Provider Demographics
NPI:1447412226
Name:REYES, EMILY DICKINSON (LCSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:DICKINSON
Last Name:REYES
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:DICKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1221
Mailing Address - Country:US
Mailing Address - Phone:860-365-1058
Mailing Address - Fax:
Practice Address - Street 1:95 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06424-1147
Practice Address - Country:US
Practice Address - Phone:860-365-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT81331041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical