Provider Demographics
NPI:1255922324
Name:EMMAUS CATHOLIC COUNSELING LLC
Entity type:Organization
Organization Name:EMMAUS CATHOLIC COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTONIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:812-670-5075
Mailing Address - Street 1:1400 MAIN ST UNIT 167
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-3117
Mailing Address - Country:US
Mailing Address - Phone:812-670-5075
Mailing Address - Fax:
Practice Address - Street 1:1400 MAIN STREET
Practice Address - Street 2:SUITE 167
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129
Practice Address - Country:US
Practice Address - Phone:812-217-7135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)