Provider Demographics
NPI:1114295706
Name:HEIRD, EMILY (LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HEIRD
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 EARLY WOODS LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6689
Mailing Address - Country:US
Mailing Address - Phone:865-776-0667
Mailing Address - Fax:865-381-1859
Practice Address - Street 1:10414 JACKSON OAKS WAY STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-0704
Practice Address - Country:US
Practice Address - Phone:865-776-0667
Practice Address - Fax:865-381-1859
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006132Medicaid