Provider Demographics
NPI:1326825464
Name:EMOVERE THERAPY, PLLC
Entity Type:Organization
Organization Name:EMOVERE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, R-DMT
Authorized Official - Phone:262-328-6139
Mailing Address - Street 1:4610 N CLARK ST # 1275
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-4620
Mailing Address - Country:US
Mailing Address - Phone:262-328-6139
Mailing Address - Fax:
Practice Address - Street 1:4311 N RAVENSWOOD AVE STE 203
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1192
Practice Address - Country:US
Practice Address - Phone:262-328-6139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health