MEDICARE: TORI JADE EMERICK 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	LPC0013194	GA

General Provider Information

NPI Number	:	1265068068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TORI JADE EMERICK LPC

Provider Business Mailing Address
First Line	:	231 S CARROLL RD
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-2607
Country	:	US
Telephone Number	:	770-597-9362
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 S CARROLL RD
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-2607
Country	:	US
Telephone Number	:	770-810-5211
Fax Number	:

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

Provider Enumeration Date	:	03/12/2020
Last Update Date	:	03/23/2026

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