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General NPI Number Information
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NPI Number | 1346570082
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Entity Type | Organization
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Legal Business Name | EMERY BEHAVIORAL HEALTH SERVICES, INC
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 02/22/2011
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Provider Practice Location Address
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Address Line | 235 MARKET ST SUITE 2
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City | SUNBURY
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State | PA
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Zip | 17801-3401
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Country | US
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Telephone | 570-286-0987
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Fax | 570-286-0989
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Provider Business Mailing Address
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Address Line | 32 WHISPER CREEK DR SUITE 7
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City | LEWISBURG
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State | PA
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Zip | 17837-7770
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Country | US
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Telephone | 570-522-0304
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Fax | 570-522-0475
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Authorized Official
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Title or Position | VICE PRESIDENT/DIRECTOR OF OPERATIO
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Name | MR. DUSTIN EMERY
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Credential | MSED
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Telephone | 570-522-0304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW013397L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW126648
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW015380
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS015898
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License Number State | PA
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