Healthcare Provider Details

I. General information

NPI: 1992628374
Provider Name (Legal Business Name): EMILY SAMANIEGO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RED SAMANIEGO LMSW

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 FORT GREENE PL
BROOKLYN NY
11217-1203
US

IV. Provider business mailing address

4018 5TH AVE APT 14
BROOKLYN NY
11232-3404
US

V. Phone/Fax

Practice location:
  • Phone: 520-347-0160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number128921
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: