Provider Demographics
NPI:1922313626
Name:EMBRY, LINDA I (LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:I
Last Name:EMBRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E 10TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5018
Mailing Address - Country:US
Mailing Address - Phone:212-780-2300
Mailing Address - Fax:646-602-9369
Practice Address - Street 1:315 E 10TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-5018
Practice Address - Country:US
Practice Address - Phone:212-780-2300
Practice Address - Fax:646-602-9369
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0725311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical