MEDICARE: MS. EMMA SOMMERS 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	37AC00511200	NJ
2	101YP2500X	Professional Counselor	37PC00900200	NJ

General Provider Information

NPI Number	:	1215560180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMMA SOMMERS LPC

Provider Business Mailing Address
First Line	:	312 14TH AVE
Second Line	:
City	:	BELMAR
State	:	NJ
Zip	:	07719-2514
Country	:	US
Telephone Number	:	908-279-4661
Fax Number	:

Provider Business Practice Location Address
First Line	:	181 SOUTH ST UNIT B1
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-2164
Country	:	US
Telephone Number	:	908-279-4661
Fax Number	:

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

Provider Enumeration Date	:	02/19/2020
Last Update Date	:	01/15/2023

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