Emily D Brassard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089691-01 Issued in NY

Practice address

1120 Route 72
Suite 300
Mount Laurel, NJ 08054-0805

Phone

(856) 372-0994

Fax

(856) 861-1364

NPI assigned

Jun 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1265009807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SAWYER LN",
            "city": "SAUGERTIES",
            "state": "NY",
            "postal_code": "124774252",
            "telephone_number": "845-417-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 ROUTE 72",
            "address_2": "SUITE 300",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080540805",
            "telephone_number": "856-372-0994",
            "fax_number": "856-861-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASSARD",
        "first_name": "EMILY",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089691-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW LICENSE",
            "identifier": "084390-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE",
            "identifier": "089691-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Boyd, RN
• Braden Partners LP
• Bradley J Convissar DMD PA
• Branches of Hope
• Warren I Brandwine, D.O.
• Joshua G Bravo
• Breg, Inc.
• Allan Stuart Brenner, D.D.S.
• Kristina Brenner, MSOT, OTR/L
• Brett Dinovi & Associates

• Clinical Social Worker in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.