Healthcare Provider Details

I. General information

NPI: 1326872771
Provider Name (Legal Business Name): JOSEPH EMANUEL MILLWOOD LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MAPLE ST
SPRINGFIELD MA
01103-1930
US

IV. Provider business mailing address

212 FUNSTON AVE
TORRINGTON CT
06790-6220
US

V. Phone/Fax

Practice location:
  • Phone: 413-707-8100
  • Fax:
Mailing address:
  • Phone: 475-377-8367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW230654
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16904
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: