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NPI Code Detail

MEDICARE: EMMY VAN DORN

MEDICARE: EMMY VAN DORN
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1982520052
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMY VAN DORN
Provider Business Mailing Address
First Line : 1145 SAGAMORE AVE
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-5585
Country : US
Telephone Number : 603-431-6703
Fax Number : 603-430-3753
Provider Business Practice Location Address
First Line : 1145 SAGAMORE AVE
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-5585
Country : US
Telephone Number : 603-431-6703
Fax Number : 603-430-3753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2026
Last Update Date : 06/24/2026

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Directions to “ EMMY VAN DORN ” Practice Location

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