Provider Demographics
NPI:1104608447
Name:MASSEY, EMMELINE HESTER (MSW, LSW)
Entity type:Individual
Prefix:
First Name:EMMELINE HESTER
Middle Name:
Last Name:MASSEY
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 1:1707 STONE HOUSE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-3494
Mailing Address - Country:US
Mailing Address - Phone:970-406-2283
Mailing Address - Fax:
Practice Address - Street 1:1707 STONE HOUSE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-3494
Practice Address - Country:US
Practice Address - Phone:970-406-2283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107451104100000X
COLSW.0009923366104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker