Provider Demographics
NPI:1053778985
Name:EMERGE COUNSELING, LLC
Entity type:Organization
Organization Name:EMERGE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL CLINICAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PCC
Authorized Official - Phone:937-776-4339
Mailing Address - Street 1:70 BIRCH ALY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-1479
Mailing Address - Country:US
Mailing Address - Phone:937-776-4339
Mailing Address - Fax:937-350-5216
Practice Address - Street 1:70 BIRCH ALY
Practice Address - Street 2:SUITE 240
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-1479
Practice Address - Country:US
Practice Address - Phone:937-776-4339
Practice Address - Fax:937-350-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0600268101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty