Provider Demographics
NPI:1194017327
Name:WHITTLE, EMI (MED, LPC, LPC-S,NCC)
Entity Type:Individual
Prefix:
First Name:EMI
Middle Name:
Last Name:WHITTLE
Suffix:
Gender:F
Credentials:MED, LPC, LPC-S,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 120
Mailing Address - Street 2:
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565-0120
Mailing Address - Country:US
Mailing Address - Phone:281-826-4364
Mailing Address - Fax:
Practice Address - Street 1:700 LAVACA ST STE 1401
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3101
Practice Address - Country:US
Practice Address - Phone:281-826-4364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2015-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18134101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health