Provider Demographics
NPI:1164019477
Name:EMERGE CENTER FOR SOCIAL AND EMOTIONAL LEARNING
Entity Type:Organization
Organization Name:EMERGE CENTER FOR SOCIAL AND EMOTIONAL LEARNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHWEKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:530-304-8030
Mailing Address - Street 1:1627 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1072
Mailing Address - Country:US
Mailing Address - Phone:530-304-8030
Mailing Address - Fax:
Practice Address - Street 1:1627 OAK AVE
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-1072
Practice Address - Country:US
Practice Address - Phone:530-304-8030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health