Provider Demographics
NPI:1174188056
Name:DR EMILY LLC
Entity Type:Organization
Organization Name:DR EMILY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:402-885-5090
Mailing Address - Street 1:4611 S 96TH ST STE 177
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1232
Mailing Address - Country:US
Mailing Address - Phone:402-885-5090
Mailing Address - Fax:402-575-9539
Practice Address - Street 1:4611 S 96TH ST STE 177
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1232
Practice Address - Country:US
Practice Address - Phone:402-885-5090
Practice Address - Fax:402-575-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1114240553OtherNPI