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General NPI Number Information
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NPI Number | 1992948350
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Entity Type | Individual
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Provider Name | ROBERT EMS LPC CCDP
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Gender | Male
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 38 CASTLE ROCK ACRES
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City | EAST STROUDSBURG
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State | PA
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Zip | 18302-8989
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Country | US
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Telephone | 570-223-6682
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Fax |
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Provider Business Mailing Address
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Address Line | 162 CASTLE DR
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City | EAST STROUDSBURG
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State | PA
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Zip | 18302-6845
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Country | US
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Telephone | 570-856-4759
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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 | 300228
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC007987
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License Number State | PA
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