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General NPI Number Information
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NPI Number | 1932422441
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Entity Type | Individual
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Provider Name | PATRICIA SUE EMERY LCPC,CAADC
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Gender | Female
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 319 1/2 W STATE ST SUITEA
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City | GENEVA
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State | IL
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Zip | 60134-2167
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Country | US
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Telephone | 630-723-1083
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Fax |
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Provider Business Mailing Address
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Address Line | 811 LOGAN AVE
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City | GENEVA
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State | IL
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Zip | 60134-1126
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Country | US
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Telephone | 630-208-6713
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAADC (CERTIFICATION
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MAC (CERTIFICATION)
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.000146
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License Number State | IL
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