Healthcare Provider Details

I. General information

NPI: 1346994977
Provider Name (Legal Business Name): EMERGE COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6245 SWEET GUM DR
WILMINGTON NC
28409-6201
US

IV. Provider business mailing address

6245 SWEET GUM DR
WILMINGTON NC
28409-6201
US

V. Phone/Fax

Practice location:
  • Phone: 910-624-1062
  • Fax:
Mailing address:
  • Phone: 910-624-1062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SHARINETTA NICOLE MURRAY
Title or Position: THERAPIST
Credential: LCMHC
Phone: 910-624-1062