Provider Demographics
NPI:1396094116
Name:IMONDI, EMILY ANN (MSED, MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ANN
Last Name:IMONDI
Suffix:
Gender:F
Credentials:MSED, MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 PLANDOME RD # 131
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1945
Mailing Address - Country:US
Mailing Address - Phone:516-993-0852
Mailing Address - Fax:
Practice Address - Street 1:30 DERBY RD
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-4223
Practice Address - Country:US
Practice Address - Phone:516-993-0852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015138-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health