Individual
EMERSON NICOLAS DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, NCC, LPC
Contact information
Practice address
3112 SIMPSON HIGHWAY 13, MENDENHALL, MS 39114-3076
(601) 622-3056
Mailing address
3112 SIMPSON HIGHWAY 13, MENDENHALL, MS 39114-3076
(601) 622-3056
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
3041
MS
101YP2500X
Professional Counselor
—
MS
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
03/15/2021
Last updated
07/17/2024
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