Provider Demographics
NPI:1972135606
Name:EMERGENT LEARNING, LLC
Entity type:Organization
Organization Name:EMERGENT LEARNING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA-D
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LBA, MO
Authorized Official - Phone:314-275-0506
Mailing Address - Street 1:11780 BORMAN DR STE 400
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4135
Mailing Address - Country:US
Mailing Address - Phone:314-275-0506
Mailing Address - Fax:
Practice Address - Street 1:11780 BORMAN DR STE 400
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4135
Practice Address - Country:US
Practice Address - Phone:314-275-0506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty