Provider Demographics
NPI:1700629334
Name:EMERALD PATH THERAPY LLC
Entity type:Organization
Organization Name:EMERALD PATH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:MEI ZHIN
Authorized Official - Last Name:YONG
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:630-345-6345
Mailing Address - Street 1:2325 DEAN ST STE 800L
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-4813
Mailing Address - Country:US
Mailing Address - Phone:630-345-6345
Mailing Address - Fax:
Practice Address - Street 1:2325 DEAN ST STE 800L
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-4813
Practice Address - Country:US
Practice Address - Phone:630-345-6345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty