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General NPI Number Information
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NPI Number | 1134834062
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Entity Type | Individual
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Provider Name | EMILY M SOCOLA-MCCORMICK MA
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Gender | Female
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 2667 CAMINO DEL RIO S STE 203
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City | SAN DIEGO
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State | CA
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Zip | 92108-3733
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Country | US
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Telephone | 619-887-4243
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Fax |
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Provider Business Mailing Address
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Address Line | 12509 CASTLE COURT DR
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City | LAKESIDE
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State | CA
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Zip | 92040-4226
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Country | US
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Telephone | 864-992-0554
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APCC12197
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License Number State | CA
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