Provider Demographics
NPI:1922235274
Name:DOLAN, EMILY VIRGINIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:VIRGINIA
Last Name:DOLAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:VIRGINIA
Other - Last Name:BRIGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:199 MATTHEWS RD.
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11769
Mailing Address - Country:US
Mailing Address - Phone:917-650-9107
Mailing Address - Fax:631-370-1714
Practice Address - Street 1:199 MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769
Practice Address - Country:US
Practice Address - Phone:917-650-9107
Practice Address - Fax:631-370-1714
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-14
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071224-11041C0700X
NYR071224-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical