Healthcare Provider Details

I. General information

NPI: 1104689629
Provider Name (Legal Business Name): EMERSON COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 DISCOVERY DR STE 114
BOZEMAN MT
59718-4134
US

IV. Provider business mailing address

PO BOX 11992
BOZEMAN MT
59719-1992
US

V. Phone/Fax

Practice location:
  • Phone: 406-582-0448
  • Fax:
Mailing address:
  • Phone: 406-582-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JANICE EMERSON
Title or Position: PRESIDENT
Credential: MS, LCPC
Phone: 406-582-0448