Provider Demographics
NPI:1598550261
Name:AZCONA, EMILY (MSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:AZCONA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 BEECHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8329
Mailing Address - Country:US
Mailing Address - Phone:812-767-5752
Mailing Address - Fax:
Practice Address - Street 1:554 PIT RD STE 211
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-9555
Practice Address - Country:US
Practice Address - Phone:317-203-9578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99129461A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker