Provider Demographics
NPI:1164164166
Name:WIGGLESWORTH, EMILY JANE (LPC, LCPC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JANE
Last Name:WIGGLESWORTH
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4447 ALBEMARLE ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2013
Mailing Address - Country:US
Mailing Address - Phone:202-997-0448
Mailing Address - Fax:
Practice Address - Street 1:1420 SPRING ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2701
Practice Address - Country:US
Practice Address - Phone:240-847-7504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8215101YP2500X
DCPRC14857101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional