Provider Demographics
NPI:1770234239
Name:EMILY MIDWOOD,LCSW PLLC
Entity Type:Organization
Organization Name:EMILY MIDWOOD,LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:413-225-1477
Mailing Address - Street 1:32 BEILKE RD
Mailing Address - Street 2:
Mailing Address - City:MILLERTON
Mailing Address - State:NY
Mailing Address - Zip Code:12546-4943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:348 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:CT
Practice Address - Zip Code:06039-1232
Practice Address - Country:US
Practice Address - Phone:413-225-1477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health