Provider Demographics
NPI:1063005080
Name:EMERGE PSYCHOLOGY GROUP LLC
Entity Type:Organization
Organization Name:EMERGE PSYCHOLOGY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PASCALE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MA
Authorized Official - Phone:872-228-6416
Mailing Address - Street 1:1700 W IRVING PARK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2596
Mailing Address - Country:US
Mailing Address - Phone:872-228-6416
Mailing Address - Fax:
Practice Address - Street 1:1700 W IRVING PARK RD STE 104
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2596
Practice Address - Country:US
Practice Address - Phone:872-228-6416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty