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Organization

EMMAUS,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNA MARIE LOPICCOLO MS, LMFT (PRESIDENT)
(860) 384-2552
Entity
Organization

Contact information

Practice address
131 SADDLEBROOK PATH, SOUTHINGTON, CT 06489-4423
(860) 621-6023
Mailing address
131 SADDLEBROOK PATH, SOUTHINGTON, CT 06489-4423
(860) 621-6023

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
CT000779
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004244125
CT
01
410000779CT01
ANTHEM PROVIDER NUMBER
CT
01
62-59512
UBH PROVIDER NUMBER
CT
Enumeration date
07/12/2006
Last updated
11/13/2008
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