Healthcare Provider Details

I. General information

NPI: 1346570082
Provider Name (Legal Business Name): EMERY BEHAVIORAL HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 MARKET ST SUITE 2
SUNBURY PA
17801-3401
US

IV. Provider business mailing address

32 WHISPER CREEK DR SUITE 7
LEWISBURG PA
17837-7770
US

V. Phone/Fax

Practice location:
  • Phone: 570-286-0987
  • Fax: 570-286-0989
Mailing address:
  • Phone: 570-522-0304
  • Fax: 570-522-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS015898
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW013397L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW126648
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW015380
License Number StatePA

VIII. Authorized Official

Name: MR. DUSTIN EMERY
Title or Position: VICE PRESIDENT/DIRECTOR OF OPERATIO
Credential: MSED
Phone: 570-522-0304