Emily Medina, LCSW, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007837 Issued in CT

Legal business name

EMILY MEDINA, LCSW, LLC

Practice address

2 Ivy Brook Rd
Shelton, CT 06484-6416

Phone

(203) 446-6486

NPI assigned

Feb 5, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emily MedinaNPI 1639321664

Title

LCSW

Phone

(203) 446-6486

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emily R Medina, LCSW

  • Clinical Social Worker
  • Ansonia, CT
  • NPI 1639321664
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1114318656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MORNINGSIDE DR",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064011312",
            "telephone_number": "203-446-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 IVY BROOK RD",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846416",
            "telephone_number": "203-446-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMILY MEDINA, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "203-446-6486"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie M. Elledge
• Daphne Elliott, LCSW
• Lauryn Anne Ellis, OTR/L
• Deborah Ann Ellison, APRN
• Ellmak Personal Assistance Services LLC
• Empowerment Strategic Solutions
• Enhanced Care Initiatives
• Enzo Clinical Labs, Inc.
• Alisha Erickson, RDH
• Breann Sara Erickson, RD

• Clinical Social Worker in Shelton, CT
• Providers in Shelton, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.