Provider Demographics
NPI:1659073773
Name:PRUSAK, EMILY (MSW, LSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PRUSAK
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 KENSINGTON PL W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-2370
Mailing Address - Country:US
Mailing Address - Phone:614-441-5136
Mailing Address - Fax:
Practice Address - Street 1:8001 RAVINES EDGE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5423
Practice Address - Country:US
Practice Address - Phone:614-441-5136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker