Provider Demographics
NPI:1134950009
Name:VETRANO, EMILY MCMILLAN (LMSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MCMILLAN
Last Name:VETRANO
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 1:138 MOUNTAINVIEW RD
Mailing Address - Street 2:
Mailing Address - City:TILLSON
Mailing Address - State:NY
Mailing Address - Zip Code:12486-1228
Mailing Address - Country:US
Mailing Address - Phone:248-632-2576
Mailing Address - Fax:
Practice Address - Street 1:200 AARON CT
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2963
Practice Address - Country:US
Practice Address - Phone:845-331-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124007104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker