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7071 Corporate Way Suite 104 Centerville Finance OH 45459-8911 | |
| (937) 434-2100 | |
| (937) 439-3747 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Addiction (substance Use Disorder) |
| Location | 7071 Corporate Way, Centerville Finance, Ohio |
| Authorized Official Name and Position | Stephen Wayne Emerick (PSYCHOLOGIST) |
| Authorized Official Contact | 9374342100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7071 Corporate Way Suite 104 Centerville Finance OH 45459-8911 Ph: (937) 434-2100 | 7071 Corporate Way Suite 104 Centerville Finance OH 45459-8911 Ph: (937) 434-2100 |
| NPI Number | 1083837900 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083837900 | NPI | - | NPPES |
| 0738027 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 4189 (Ohio) | Primary |
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | 90281 (Ohio) | Primary |