Healthcare Provider Details

I. General information

NPI: 1922793504
Provider Name (Legal Business Name): EMMA NOVICK LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 20TH ST
BROOKLYN NY
11232-1253
US

IV. Provider business mailing address

2207 19TH ST APT A
ASTORIA NY
11105-3647
US

V. Phone/Fax

Practice location:
  • Phone: 646-685-4422
  • Fax:
Mailing address:
  • Phone: 631-759-6992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102131
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: