Provider Demographics
NPI:1063678084
Name:KIRBY, EMILY (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KIRBY
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15335 EDGEHILL DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1033
Mailing Address - Country:US
Mailing Address - Phone:985-264-7204
Mailing Address - Fax:
Practice Address - Street 1:13600 MINNIEVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-2369
Practice Address - Country:US
Practice Address - Phone:985-264-7204
Practice Address - Fax:772-334-2203
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68577101YP2500X
FL12039101YM0800X
LA3497101YP2500X
VA101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health