Provider Demographics
NPI:1053837245
Name:LEAHY, EMMA KATE (MS, CRC, LMHC)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:KATE
Last Name:LEAHY
Suffix:
Gender:F
Credentials:MS, CRC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 N WESTGATE RD
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-1607
Mailing Address - Country:US
Mailing Address - Phone:508-737-8590
Mailing Address - Fax:
Practice Address - Street 1:275 MILLWAY
Practice Address - Street 2:
Practice Address - City:BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02630-1102
Practice Address - Country:US
Practice Address - Phone:774-269-0649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MA11979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician