Provider Demographics
NPI:1336546795
Name:RINCAVAGE, EMILY AMBER
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:AMBER
Last Name:RINCAVAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4123
Mailing Address - Country:US
Mailing Address - Phone:571-353-5950
Mailing Address - Fax:
Practice Address - Street 1:701 NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2723
Practice Address - Country:US
Practice Address - Phone:301-766-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
MD270891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No372600000XNursing Service Related ProvidersAdult Companion