Provider Demographics
NPI:1952785636
Name:EMANUEL, LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:EMANUEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17022 130TH AVE APT 11H
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3237
Mailing Address - Country:US
Mailing Address - Phone:718-926-7764
Mailing Address - Fax:
Practice Address - Street 1:17032 130TH AVE
Practice Address - Street 2:APT 8A
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-6003
Practice Address - Country:US
Practice Address - Phone:718-926-7764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094031104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker