Provider Demographics
NPI:1639955420
Name:EMERGENT LEARNING LLC
Entity Type:Organization
Organization Name:EMERGENT LEARNING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA-D
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-275-0506
Mailing Address - Street 1:2055 CRAIGSHIRE RD STE 230
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:314-463-4937
Practice Address - Street 1:1426 E BRADFORD PKWY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-6884
Practice Address - Country:US
Practice Address - Phone:314-275-0506
Practice Address - Fax:314-463-4937
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMERGENT LEARNING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty