Provider Demographics
NPI:1487312310
Name:VANDERHOFF, EMILY (LMSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:VANDERHOFF
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:WEST WINFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:13491-0125
Mailing Address - Country:US
Mailing Address - Phone:315-813-2606
Mailing Address - Fax:
Practice Address - Street 1:7236 COUNTY HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:WEST WINFIELD
Practice Address - State:NY
Practice Address - Zip Code:13491-3710
Practice Address - Country:US
Practice Address - Phone:315-813-2606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114701104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker