| Emily Medina, Lcsw, Llc | |
|
2 Ivy Brook Rd Shelton CT 06484-6416 | |
| (203) 446-6486 | |
| Not Available |
| Full Name | Emily Medina, Lcsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2 Ivy Brook Rd, Shelton, Connecticut |
| Authorized Official Name and Position | Emily Medina (LCSW) |
| Authorized Official Contact | 2034466486 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emily Medina, Lcsw, Llc 50 Morningside Dr Ansonia CT 06401-1312 Ph: (203) 446-6486 | Emily Medina, Lcsw, Llc 2 Ivy Brook Rd Shelton CT 06484-6416 Ph: (203) 446-6486 |
| NPI Number | 1114318656 |
|---|---|
| Provider Enumeration Date | 02/05/2015 |
| Last Update Date | 02/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114318656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007837 (Connecticut) | Primary |
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