Provider Demographics
NPI:1043889918
Name:EMILY TERRELL COUNSELING, LLC
Entity Type:Organization
Organization Name:EMILY TERRELL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:337-380-9577
Mailing Address - Street 1:4023 AMBASSADOR CAFFERY PKWY STE 312
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5268
Mailing Address - Country:US
Mailing Address - Phone:337-380-9577
Mailing Address - Fax:
Practice Address - Street 1:4023 AMBASSADOR CAFFERY PKWY STE 312
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-5268
Practice Address - Country:US
Practice Address - Phone:337-380-9577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty