Provider Demographics
NPI:1104642693
Name:EMERSON MENTAL HEATLH & SUBSTANCE USE COUNSELING LLC
Entity type:Organization
Organization Name:EMERSON MENTAL HEATLH & SUBSTANCE USE COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:EMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LIMHP, LADC
Authorized Official - Phone:402-864-0778
Mailing Address - Street 1:985 MIDLAND ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NE
Mailing Address - Zip Code:68446-9736
Mailing Address - Country:US
Mailing Address - Phone:402-864-0778
Mailing Address - Fax:
Practice Address - Street 1:985 MIDLAND ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NE
Practice Address - Zip Code:68446-9736
Practice Address - Country:US
Practice Address - Phone:402-864-0778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-29
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10029090500Medicaid
NE10029404700Medicaid