Healthcare Provider Details

I. General information

NPI: 1750415857
Provider Name (Legal Business Name): PAUL MICHAEL EMRICH PH.D., LPC, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 HOPPE BLVD. FAMILY SERVICES ADMINISTRATION
ADA OK
74820
US

IV. Provider business mailing address

RESOURCE MANAGEMENT 1300 HOPPE BLVD., SUITE 1
ADA OK
74820
US

V. Phone/Fax

Practice location:
  • Phone: 580-272-1180
  • Fax:
Mailing address:
  • Phone: 580-436-7211
  • Fax: 580-272-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2848
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number796
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: