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General NPI Number Information
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NPI Number | 1588394415
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Entity Type | Organization
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Legal Business Name | EMERGE COUNSELING LLC
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 1820 GLYNWOOD DR STE B
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City | PRATTVILLE
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State | AL
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Zip | 36066-5533
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Country | US
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Telephone | 334-358-2455
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 GLYNWOOD DR STE B
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City | PRATTVILLE
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State | AL
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Zip | 36066-5533
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Country | US
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Telephone | 334-358-3455
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES EDWIN THOMAS III
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Credential | MS, LPC
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Telephone | 334-358-2455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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