Provider Demographics
NPI:1598191413
Name:ERNST, EMERIE L (LISW)
Entity type:Individual
Prefix:
First Name:EMERIE
Middle Name:L
Last Name:ERNST
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:EMERIE
Other - Middle Name:L
Other - Last Name:VATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2826 W LOCUST ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-3354
Mailing Address - Country:US
Mailing Address - Phone:563-445-8710
Mailing Address - Fax:563-445-8673
Practice Address - Street 1:2826 W LOCUST ST STE 2A
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-3354
Practice Address - Country:US
Practice Address - Phone:563-445-8710
Practice Address - Fax:563-445-8673
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0075691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical