MEDICARE: EMILY HOLGEN MS, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C7591	OR

General Provider Information

NPI Number	:	1013369354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY HOLGEN MS, LPC

Provider Business Mailing Address
First Line	:	960 BELLVIEW AVE
Second Line	:
City	:	ASHLAND
State	:	OR
Zip	:	97520-3604
Country	:	US
Telephone Number	:	541-414-4016
Fax Number	:

Provider Business Practice Location Address
First Line	:	960 BELLVIEW AVE
Second Line	:
City	:	ASHLAND
State	:	OR
Zip	:	97520-3604
Country	:	US
Telephone Number	:	541-414-4016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2016
Last Update Date	:	07/25/2024

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