Provider Demographics
NPI:1689342446
Name:EMERALD COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:EMERALD COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AVRON
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-348-6148
Mailing Address - Street 1:323 KERRIGAN BLVD APT 4
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-3455
Mailing Address - Country:US
Mailing Address - Phone:908-913-0677
Mailing Address - Fax:
Practice Address - Street 1:323 KERRIGAN BLVD APT 4
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-3455
Practice Address - Country:US
Practice Address - Phone:908-913-0677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-04
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health