Provider Demographics
NPI:1194460915
Name:KURJAKOVIC, EMERSON DAVID (MS, LPC)
Entity Type:Individual
Prefix:
First Name:EMERSON
Middle Name:DAVID
Last Name:KURJAKOVIC
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 ATWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-4133
Mailing Address - Country:US
Mailing Address - Phone:412-708-8096
Mailing Address - Fax:
Practice Address - Street 1:1099 DAVIS RD
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-8019
Practice Address - Country:US
Practice Address - Phone:724-602-2224
Practice Address - Fax:724-218-3958
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional