Provider Demographics
NPI:1033862875
Name:EMERGING HOPE BEHAVIORAL SERVICES, LLC
Entity Type:Organization
Organization Name:EMERGING HOPE BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MATTIE
Authorized Official - Middle Name:DIANN
Authorized Official - Last Name:TOWNS-SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S, LICDC
Authorized Official - Phone:216-224-7080
Mailing Address - Street 1:5845 ROBERTDALE RD
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2549
Mailing Address - Country:US
Mailing Address - Phone:216-224-7989
Mailing Address - Fax:440-439-4548
Practice Address - Street 1:5845 ROBERTDALE RD
Practice Address - Street 2:
Practice Address - City:OAKWOOD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44146-2549
Practice Address - Country:US
Practice Address - Phone:216-224-7989
Practice Address - Fax:440-439-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1065293OtherBEACON HEALTH OPTIONS
14656494OtherCAQH
OHMDTS25493014OtherOPTUM
5787580OtherEVERNORTH CARE SOLUTIONS, INC.
OH0402056Medicaid
OH601461575OtherMAGELLAN
OH1341660OtherCARESOURCE
5787580OtherEVERNORTH CARE SOLUTIONS, INC