MEDICARE: EMILY ALANA GORELICK

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	A16760	NC

General Provider Information

NPI Number	:	1689247090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ALANA GORELICK

Provider Business Mailing Address
First Line	:	8619 RITTENHOUSE CIR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-1094
Country	:	US
Telephone Number	:	914-924-4871
Fax Number	:

Provider Business Practice Location Address
First Line	:	8105 SULLIVAN DRIVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215
Country	:	US
Telephone Number	:	704-426-3453
Fax Number	:

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

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	05/30/2023

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