Provider Demographics
NPI:1518725837
Name:EMERSON, GLORIA E (LCSW)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:E
Last Name:EMERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GLO
Other - Middle Name:
Other - Last Name:EMERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:67 S HIGLEY RD STE 103-479
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1166
Mailing Address - Country:US
Mailing Address - Phone:602-456-9848
Mailing Address - Fax:
Practice Address - Street 1:67 S HIGLEY RD STE 103-479
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1166
Practice Address - Country:US
Practice Address - Phone:602-456-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011174481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical