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General NPI Number Information
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NPI Number | 1770234239
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Entity Type | Organization
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Legal Business Name | EMILY MIDWOOD,LCSW PLLC
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Dates
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Enumeration Date | 01/15/2022
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Last Update Date | 01/15/2022
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Provider Practice Location Address
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Address Line | 348 MAIN ST
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City | LAKEVILLE
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State | CT
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Zip | 06039-1232
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Country | US
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Telephone | 413-225-1477
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Fax |
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Provider Business Mailing Address
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Address Line | 32 BEILKE RD
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City | MILLERTON
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State | NY
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Zip | 12546-4943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | EMILY MIDWOOD
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Credential | LCSW
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Telephone | 413-225-1477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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