Organization Name: | EMERGE COUNSELING, LLC |
NPI Number: | 1053778985 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICOLE M HOLBROOK (PROFESSIONAL CLINICAL COUNSELOR) |
Mailing Address: | 70 Birch Aly Suite 240 Beavercreek |
State: | OH US |
Postal Code: | 454401479 |
Phone Number: | 9377764339 |
Fax Number: | 9373505216 |
NPI Enumeration Date: | 01/22/2016 |
NPI Last Update Date: | 01/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | E. 0600268 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |