Provider Demographics
NPI: | 1306622410 |
---|---|
Name: | EMOVERE THERAPY AND INTENSIVES, LLC |
Entity type: | Organization |
Organization Name: | EMOVERE THERAPY AND INTENSIVES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JESSICA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SCHROEDER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS, LCMFT, LMFT |
Authorized Official - Phone: | 913-565-2131 |
Mailing Address - Street 1: | 205 S 5TH ST STE 22 |
Mailing Address - Street 2: | |
Mailing Address - City: | LEAVENWORTH |
Mailing Address - State: | KS |
Mailing Address - Zip Code: | 66048-2602 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 913-565-2131 |
Mailing Address - Fax: | 913-225-7984 |
Practice Address - Street 1: | 205 S 5TH ST STE 22 |
Practice Address - Street 2: | |
Practice Address - City: | LEAVENWORTH |
Practice Address - State: | KS |
Practice Address - Zip Code: | 66048-2602 |
Practice Address - Country: | US |
Practice Address - Phone: | 913-565-2131 |
Practice Address - Fax: | 913-225-7984 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-09-05 |
Last Update Date: | 2023-09-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |