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General NPI Number Information
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NPI Number | 1104593193
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Entity Type | Organization
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Legal Business Name | THERAPY EMPORIUM LLC
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 321 MAIN ST
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City | GREAT BARRINGTON
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State | MA
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Zip | 01230-1745
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Country | US
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Telephone | 413-613-5909
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Fax |
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Provider Business Mailing Address
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Address Line | 740 MAIN STREET SUITE 1
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City | GREAT BARRINGTON
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State | MA
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Zip | 01230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. HEATHER LYONS
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Credential | PH.D.
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Telephone | 413-613-5909
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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