Provider Demographics
NPI:1891197042
Name:EMANUELE, LOUIS (BA, CCDP)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:EMANUELE
Suffix:
Gender:M
Credentials:BA, CCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 DURHAM PL
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1245
Mailing Address - Country:US
Mailing Address - Phone:267-340-8209
Mailing Address - Fax:
Practice Address - Street 1:716 DURHAM PL
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-1245
Practice Address - Country:US
Practice Address - Phone:267-340-8209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8064101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)