Provider Demographics
NPI:1265068068
Name:EMERICK, TORI JADE (LPC)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:JADE
Last Name:EMERICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 LAKE PARK DR SE STE 216
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-7642
Mailing Address - Country:US
Mailing Address - Phone:770-597-9362
Mailing Address - Fax:
Practice Address - Street 1:1850 LAKE PARK DR SE STE 216
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7642
Practice Address - Country:US
Practice Address - Phone:770-810-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC0013194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health