Provider Demographics
NPI:1396097366
Name:CASALE, EMILIA (LGSW)
Entity type:Individual
Prefix:MISS
First Name:EMILIA
Middle Name:
Last Name:CASALE
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 E DIAMOND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-5321
Mailing Address - Country:US
Mailing Address - Phone:301-840-3200
Mailing Address - Fax:301-840-1348
Practice Address - Street 1:610 E DIAMOND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-5321
Practice Address - Country:US
Practice Address - Phone:301-840-3200
Practice Address - Fax:301-840-1348
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18196101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD18196OtherLGSW STATE LICENSE