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General NPI Number Information
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NPI Number | 1033170451
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Entity Type | Individual
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Provider Name | MARY ALICE EMERT LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 10/28/2013
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Provider Practice Location Address
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Address Line | 219 S EDGEWOOD AVE
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City | SOMERSET
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State | PA
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Zip | 15501-1936
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Country | US
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Telephone | 814-444-9525
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Fax | 814-444-8526
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Provider Business Mailing Address
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Address Line | 1407 EISENHOWER BLVD SUITE 104
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City | JOHNSTOWN
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State | PA
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Zip | 15904-3262
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Country | US
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Telephone | 814-269-1494
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Fax | 814-266-8572
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW014717
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License Number State | PA
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