Provider Demographics
NPI:1336533124
Name:EMERSON, SAFFRONE G (LMHC, NCC, MA)
Entity Type:Individual
Prefix:MS
First Name:SAFFRONE
Middle Name:G
Last Name:EMERSON
Suffix:
Gender:F
Credentials:LMHC, NCC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 BREVARD AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-7973
Mailing Address - Country:US
Mailing Address - Phone:321-632-5792
Mailing Address - Fax:
Practice Address - Street 1:505 BREVARD AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7973
Practice Address - Country:US
Practice Address - Phone:321-632-5792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 13239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH 13239OtherFLORIDA DEPARTMENT OF HEALTH