Provider Demographics
NPI:1740540111
Name:MARKOWITZ BAILEY, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MARKOWITZ BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:MARKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, LCSW
Mailing Address - Street 1:809 S DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4813
Mailing Address - Country:US
Mailing Address - Phone:323-642-8422
Mailing Address - Fax:
Practice Address - Street 1:809 S DETROIT ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4813
Practice Address - Country:US
Practice Address - Phone:323-642-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-20
Last Update Date:2012-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072406-1104100000X
CALCS 281381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker