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General NPI Number Information
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NPI Number | 1730493545
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Entity Type | Individual
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Provider Name | AMY SUSAN EMERT LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 44899 CENTRE CT
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City | CLINTON TWP
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State | MI
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Zip | 48038-5510
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Country | US
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Telephone | 586-792-1654
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Fax |
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Provider Business Mailing Address
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Address Line | 3940 LONG MEADOW LN
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City | LAKE ORION
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State | MI
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Zip | 48359-1465
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Country | US
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Telephone | 248-393-1086
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801092057
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License Number State | MI
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