Provider Demographics
NPI:1295067619
Name:PLANK, EMILY S (PCCS, NCC, CDCA, ATR)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:S
Last Name:PLANK
Suffix:
Gender:F
Credentials:PCCS, NCC, CDCA, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11811 SHAKER BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1931
Mailing Address - Country:US
Mailing Address - Phone:216-229-2420
Mailing Address - Fax:216-229-2474
Practice Address - Street 1:11811 SHAKER BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1931
Practice Address - Country:US
Practice Address - Phone:216-229-2420
Practice Address - Fax:216-229-2474
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH050481101YA0400X
OHE 0500923101YM0800X
OH237535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional