Provider Demographics
NPI:1841817095
Name:BRYAN, EMILY J (LPCC)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:J
Last Name:BRYAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMMUNITY SUPPORT SERVICES, INC.
Mailing Address - Street 2:150 CROSS STREET
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1026
Mailing Address - Country:US
Mailing Address - Phone:330-253-9388
Mailing Address - Fax:330-376-6726
Practice Address - Street 1:COMMUNITY SUPPORT SERVICES, INC.
Practice Address - Street 2:150 CROSS ST.
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1026
Practice Address - Country:US
Practice Address - Phone:330-253-9388
Practice Address - Fax:330-376-6726
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2303810101YP2500X
OHC2002801TRN101Y00000X
OHCDCA.175370101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)