Basic Information
Provider Information
NPI: 1295085108
EntityType: 2
ReplacementNPI:  
OrganizationName: EMMONS COUNSELING, LLC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 6744
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701746744
CountryCode: US
TelephoneNumber: 5043097844
FaxNumber: 5043097845
Practice Location
Address1: 705 FRANKLIN AVE
Address2:  
City: GRETNA
State: LA
PostalCode: 700532117
CountryCode: US
TelephoneNumber: 5046845281
FaxNumber: 5043097845
Other Information
ProviderEnumerationDate: 09/18/2012
LastUpdateDate: 09/18/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: EMMONS
AuthorizedOfficialFirstName: BETH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 2062189571
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: LCSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XLCSW11088LAY193400000X SINGLE SPECIALTY GROUPBehavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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