MEDICARE: EMILY WOLFF NEWMANN LICSW

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
1	104100000X	Social Worker	112079	MA
2	1041C0700X	Clinical Social Worker	112079

General Provider Information

NPI Number	:	1881656726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY WOLFF NEWMANN LICSW

Provider Business Mailing Address
First Line	:	288 WALNUT ST STE 220
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02460-1994
Country	:	US
Telephone Number	:	617-899-1303
Fax Number	:

Provider Business Practice Location Address
First Line	:	288 WALNUT ST STE 220
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02460-1994
Country	:	US
Telephone Number	:	617-899-1303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	08/19/2020

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