Provider Demographics
NPI:1356122188
Name:OHLUND, EMMA (LMSW)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:OHLUND
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 1:977 STATE ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3962
Mailing Address - Country:US
Mailing Address - Phone:860-924-8326
Mailing Address - Fax:
Practice Address - Street 1:977 STATE ST APT 2C
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3962
Practice Address - Country:US
Practice Address - Phone:860-924-8326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT66331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty