Provider Demographics
NPI:1730493545
Name:EMERT, AMY SUSAN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUSAN
Last Name:EMERT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 LONG MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-1465
Mailing Address - Country:US
Mailing Address - Phone:248-393-1086
Mailing Address - Fax:
Practice Address - Street 1:44899 CENTRE CT
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-5510
Practice Address - Country:US
Practice Address - Phone:586-792-1654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010920571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical