Provider Demographics
NPI:1851198816
Name:EMAMI, BEHRAD (LPC)
Entity type:Individual
Prefix:MR
First Name:BEHRAD
Middle Name:
Last Name:EMAMI
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 E ROUMFORT RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1632
Mailing Address - Country:US
Mailing Address - Phone:267-240-7243
Mailing Address - Fax:
Practice Address - Street 1:1107 MANTUA PIKE STE 720
Practice Address - Street 2:#102
Practice Address - City:MANTUA
Practice Address - State:NJ
Practice Address - Zip Code:08051
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC018190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty