Provider Demographics
NPI:1982474953
Name:EMILY FUMAROLA WELLNESS & COUNSELING LLC
Entity type:Organization
Organization Name:EMILY FUMAROLA WELLNESS & COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:FUMAROLA
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:937-728-7707
Mailing Address - Street 1:810 EASTGATE NORTH DRIVE
Mailing Address - Street 2:SUITE 200 MAILBOX 328
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245
Mailing Address - Country:US
Mailing Address - Phone:937-728-7707
Mailing Address - Fax:
Practice Address - Street 1:1520 S STATE ROUTE 133
Practice Address - Street 2:
Practice Address - City:BLANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45107-8483
Practice Address - Country:US
Practice Address - Phone:937-728-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty