Provider Demographics
NPI:1174093983
Name:EMERGENT COUNSELING AND CONSULTING LLC
Entity type:Organization
Organization Name:EMERGENT COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICKY
Authorized Official - Middle Name:SYBONIE
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CBHCMS
Authorized Official - Phone:954-533-4828
Mailing Address - Street 1:2701 W OAKLAND PARK BLVD STE 410-4
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1388
Mailing Address - Country:US
Mailing Address - Phone:954-790-0289
Mailing Address - Fax:
Practice Address - Street 1:2701 W OAKLAND PARK BLVD STE 410-4
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1388
Practice Address - Country:US
Practice Address - Phone:954-533-4828
Practice Address - Fax:754-206-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty