Provider Demographics
NPI:1932422441
Name:EMERY, PATRICIA SUE (LCPC,CAADC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUE
Last Name:EMERY
Suffix:
Gender:F
Credentials:LCPC,CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-1126
Mailing Address - Country:US
Mailing Address - Phone:630-208-6713
Mailing Address - Fax:
Practice Address - Street 1:319 1/2 W STATE ST
Practice Address - Street 2:SUITEA
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2167
Practice Address - Country:US
Practice Address - Phone:630-723-1083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCAADC (CERTIFICATION101YA0400X
ILMAC (CERTIFICATION)101YA0400X
IL180.000146101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)