Provider Demographics
NPI:1770606576
Name:EMERT, MICHAEL ALAN (LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALAN
Last Name:EMERT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 MADISON 427
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:MO
Mailing Address - Zip Code:63621-9111
Mailing Address - Country:US
Mailing Address - Phone:573-546-5115
Mailing Address - Fax:573-783-4400
Practice Address - Street 1:1116 MADISON 427
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:MO
Practice Address - Zip Code:63621-9111
Practice Address - Country:US
Practice Address - Phone:573-546-5115
Practice Address - Fax:573-783-4409
Is Sole Proprietor?:No
Enumeration Date:2007-04-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002020624101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor