Provider Demographics
NPI:1083049290
Name:VELKER, EMILY (LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:VELKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2588
Mailing Address - Country:US
Mailing Address - Phone:800-764-4806
Mailing Address - Fax:617-524-7610
Practice Address - Street 1:11 GREEN ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2588
Practice Address - Country:US
Practice Address - Phone:800-764-4806
Practice Address - Fax:617-524-7610
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3130106H00000X
390200000X
MA1777106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program