Provider Demographics
NPI:1194886671
Name:EMERGE MINISTRIES, INC.
Entity type:Organization
Organization Name:EMERGE MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIDBREDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-867-5603
Mailing Address - Street 1:900 MULL AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7502
Mailing Address - Country:US
Mailing Address - Phone:330-867-5603
Mailing Address - Fax:330-873-3439
Practice Address - Street 1:900 MULL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7502
Practice Address - Country:US
Practice Address - Phone:330-867-5603
Practice Address - Fax:330-873-3439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0002808101YP2500X
OHC8395101YP2500X
OHC0500011101YP2500X
OHE.0004392101YP2500X
OHC-0007496101YP2500X
OHE.0003226101YP2500X
OHE.0003613101YP2500X
OHE-0003876101YP2500X
OH6067103TC0700X
OH4867103TC0700X
OH5447103TC0700X
OH5280103TC0700X
OH0357242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2587875Medicaid
OH2651189Medicaid
OH2587884Medicaid
OH2587946Medicaid
OH0226188Medicaid
OH2047878Medicaid
OH2375451Medicaid
OH2587893Medicaid
OH2587900Medicaid
OH2587955Medicaid
OHCP30561Medicare ID - Type UnspecifiedPATRICIA E. BARRETT, PH.D
OHRA0407642Medicare ID - Type UnspecifiedSAM E. RAJIAH, M.D.
OH2587893Medicaid
OH0226188Medicaid
OH2587955Medicaid
OH2651189Medicaid