Provider Demographics
NPI:1164760872
Name:TONN, EMILY E (LMHC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:TONN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 DIANE CIR
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-2564
Mailing Address - Country:US
Mailing Address - Phone:321-446-2363
Mailing Address - Fax:321-574-5917
Practice Address - Street 1:180 DIANE CIR
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-2564
Practice Address - Country:US
Practice Address - Phone:321-446-2363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH10842101YM0800X
FLMH16432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health