Provider Demographics
NPI:1255592739
Name:EGZIABHER, LEMLEM (LCSW)
Entity type:Individual
Prefix:
First Name:LEMLEM
Middle Name:
Last Name:EGZIABHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 W POINT RD
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1004
Mailing Address - Country:US
Mailing Address - Phone:413-536-5473
Mailing Address - Fax:
Practice Address - Street 1:40 BOBALA RD
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-9632
Practice Address - Country:US
Practice Address - Phone:413-536-5473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0013851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical