Provider Demographics
NPI:1164448445
Name:EMERY PSYCHOLOGICAL CENTER, PA
Entity Type:Organization
Organization Name:EMERY PSYCHOLOGICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:EMERY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-395-7005
Mailing Address - Street 1:6865 SW 18TH ST STE 12
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-7057
Mailing Address - Country:US
Mailing Address - Phone:561-395-7005
Mailing Address - Fax:561-395-1243
Practice Address - Street 1:6865 SW 18TH ST STE 12
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7057
Practice Address - Country:US
Practice Address - Phone:561-395-7005
Practice Address - Fax:561-395-1243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6296101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty