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NPI Code Detail

MEDICARE: EMILY CETANYAN LSW

MEDICARE: EMILY CETANYAN LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker150.117189IL

General Provider Information

NPI Number : 1871377226
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY CETANYAN LSW
Provider Business Mailing Address
First Line : 4600 3RD ST
Second Line :
City : MOLINE
State : IL
Zip : 61265-6106
Country : US
Telephone Number : 309-779-2082
Fax Number :
Provider Business Practice Location Address
First Line : 4600 3RD ST
Second Line :
City : MOLINE
State : IL
Zip : 61265-6106
Country : US
Telephone Number : 563-779-2082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2023
Last Update Date : 04/24/2026

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Directions to “ EMILY CETANYAN LSW” Practice Location

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