Provider Demographics
NPI:1740764596
Name:COFIELD, EMILY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:COFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:COFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1618 HAVENROCK DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-6212
Mailing Address - Country:US
Mailing Address - Phone:646-595-7199
Mailing Address - Fax:
Practice Address - Street 1:1623 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1209
Practice Address - Country:US
Practice Address - Phone:718-954-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096239-01101YM0800X
0101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0Medicaid