Provider Demographics
NPI:1346904588
Name:EMOTIONAL EXPRESSIONS, LLC
Entity type:Organization
Organization Name:EMOTIONAL EXPRESSIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:STREER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:276-734-3421
Mailing Address - Street 1:1361 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-4824
Mailing Address - Country:US
Mailing Address - Phone:276-734-3421
Mailing Address - Fax:
Practice Address - Street 1:325 PINEY FOREST DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540
Practice Address - Country:US
Practice Address - Phone:276-734-3421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000000000OtherDO NOT HAVE