Provider Demographics
NPI:1639234115
Name:EMCA COUNSELING PC
Entity Type:Organization
Organization Name:EMCA COUNSELING PC
Other - Org Name:EASTERN MICHIGAN COUNSELING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:810-364-5800
Mailing Address - Street 1:1600 GRATIOT BLVD
Mailing Address - Street 2:BLDG. B, SUITE 4
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-1145
Mailing Address - Country:US
Mailing Address - Phone:810-364-5800
Mailing Address - Fax:810-364-1200
Practice Address - Street 1:1600 GRATIOT BLVD
Practice Address - Street 2:BLDG. B, SUITE 4
Practice Address - City:MARYSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48040-1145
Practice Address - Country:US
Practice Address - Phone:810-364-5800
Practice Address - Fax:810-364-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101YA0400X, 101YM0800X, 103T00000X, 103TC2200X
103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty