Provider Demographics
NPI:1689012635
Name:SAVARD, EMILY RUDOLPH (LPCA , LCASA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RUDOLPH
Last Name:SAVARD
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Gender:F
Credentials:LPCA , LCASA
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Mailing Address - Street 1:1606 WELLINGTON AVE UNIT C
Mailing Address - Street 2:COMMUNITY SUPPORT PROFESSIONALS, LLC
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7704
Mailing Address - Country:US
Mailing Address - Phone:910-799-4505
Mailing Address - Fax:910-799-4345
Practice Address - Street 1:1606 WELLINGTON AVE UNIT C
Practice Address - Street 2:COMMUNITY SUPPORT PROFESSIONALS, LLC
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7704
Practice Address - Country:US
Practice Address - Phone:910-799-4505
Practice Address - Fax:910-799-4345
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC3373A101YA0400X
NCA10067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3373AOtherNCSAPPB- NORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD
NCA10067OtherNORTH CAROLINA BOARD OF LICENSED PROFESSIONAL COUNSELORS