Healthcare Provider Details

I. General information

NPI: 1598297160
Provider Name (Legal Business Name): EMMA KUPFERMAN MSW LCSW LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 04/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 PENNSYLVANIA AVE SE
WASHINGTON DC
20003-3094
US

IV. Provider business mailing address

221 S DURHAM ST
BALTIMORE MD
21231-2606
US

V. Phone/Fax

Practice location:
  • Phone: 202-321-9715
  • Fax:
Mailing address:
  • Phone: 202-498-9368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50078786
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: