Provider Demographics
NPI:1093462921
Name:EMMERICH, MCKENNA LYNNE (MA, NCC)
Entity Type:Individual
Prefix:MS
First Name:MCKENNA
Middle Name:LYNNE
Last Name:EMMERICH
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N WASHINGTON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2535
Mailing Address - Country:US
Mailing Address - Phone:703-518-8883
Mailing Address - Fax:
Practice Address - Street 1:300 N WASHINGTON ST STE 500
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2535
Practice Address - Country:US
Practice Address - Phone:703-518-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty