Provider Demographics
NPI:1841825304
Name:MAUREEN E EMERY LCSW1 PLLC
Entity type:Organization
Organization Name:MAUREEN E EMERY LCSW1 PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:EMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-836-8884
Mailing Address - Street 1:290 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:EAST GRANBY
Mailing Address - State:CT
Mailing Address - Zip Code:06026-9524
Mailing Address - Country:US
Mailing Address - Phone:860-413-9487
Mailing Address - Fax:
Practice Address - Street 1:290 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:EAST GRANBY
Practice Address - State:CT
Practice Address - Zip Code:06026-9524
Practice Address - Country:US
Practice Address - Phone:860-836-8884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health