Healthcare Provider Details

I. General information

NPI: 1922920644
Provider Name (Legal Business Name): EMMA MARIE FOGARTY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 JEROME AVE APT 2F
MINEOLA NY
11501-3303
US

IV. Provider business mailing address

138 JEROME AVE APT 2F
MINEOLA NY
11501-3303
US

V. Phone/Fax

Practice location:
  • Phone: 413-355-0661
  • Fax:
Mailing address:
  • Phone: 413-355-0661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number121621
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: