Healthcare Provider Details

I. General information

NPI: 1679288633
Provider Name (Legal Business Name): COURTNEY L. EMERY COUNSELING AND CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 REBA PL
EVANSTON IL
60202-2616
US

IV. Provider business mailing address

705 REBA PL
EVANSTON IL
60202-2616
US

V. Phone/Fax

Practice location:
  • Phone: 414-324-1024
  • Fax:
Mailing address:
  • Phone: 414-324-1024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY EMERY
Title or Position: OWNER
Credential: MA, LCPC
Phone: 414-324-1024