Provider Demographics
NPI:1790891992
Name:DA PRADA, EMANUELA TANIA (LMSW)
Entity Type:Individual
Prefix:
First Name:EMANUELA
Middle Name:TANIA
Last Name:DA PRADA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HAVEMEYER STREET
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211
Mailing Address - Country:US
Mailing Address - Phone:718-963-4430
Mailing Address - Fax:718-963-0814
Practice Address - Street 1:217 HAVEMEYER ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-6277
Practice Address - Country:US
Practice Address - Phone:718-963-4430
Practice Address - Fax:718-963-0814
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0756741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426033245OtherFIDELIS PROVIDER NUMBER
NY040426033245OtherFIDELIS PROVIDER NUMBER