Provider Demographics
NPI:1790461366
Name:EVERLY, EMMA
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:EVERLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 OCONNELL AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5308
Mailing Address - Country:US
Mailing Address - Phone:724-880-1644
Mailing Address - Fax:
Practice Address - Street 1:100 NEW SALEM RD STE 106
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8936
Practice Address - Country:US
Practice Address - Phone:724-438-3576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)