Emerald Integrative Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EMERALD INTEGRATIVE THERAPY LLC

Practice address

136 N Main St Ste 201
Thiensville, WI 53092-1606

Phone

(715) 563-4876

NPI assigned

Jun 20, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julia Crivello, LPCNPI 1013438084

Title

Owner / Psychotherapist

Phone

(715) 563-4876

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julia Kristin Crivello

  • Professional Counselor
  • Wauwatosa, WI
  • NPI 1013438084
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1871337212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12442 N CENTER DR",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530922601",
            "telephone_number": "715-563-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N MAIN ST STE 201",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "530921606",
            "telephone_number": "715-563-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD INTEGRATIVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "CRIVELLO",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "OWNER / PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "715-563-4876",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Thiensville, WI
• Providers in Thiensville, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.