Provider Demographics
NPI:1700534013
Name:VASSAR, EMILY (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:VASSAR
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 E 84TH PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6451
Mailing Address - Country:US
Mailing Address - Phone:219-315-0631
Mailing Address - Fax:
Practice Address - Street 1:1457 E 84TH PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6451
Practice Address - Country:US
Practice Address - Phone:219-351-0631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33010701A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker