Provider Demographics
NPI:1205613353
Name:VANEGAS, EMELIN (LMSW)
Entity type:Individual
Prefix:
First Name:EMELIN
Middle Name:
Last Name:VANEGAS
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 1:26 BAY SHORE AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-7917
Mailing Address - Country:US
Mailing Address - Phone:631-575-1882
Mailing Address - Fax:
Practice Address - Street 1:26 BAY SHORE AVE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-7917
Practice Address - Country:US
Practice Address - Phone:631-575-1882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical