Provider Demographics
NPI:1235600438
Name:KIPP-WRIGHT, EMILY KAYE (MA, LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KAYE
Last Name:KIPP-WRIGHT
Suffix:
Gender:F
Credentials:MA, LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 FALKIRK DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2613
Mailing Address - Country:US
Mailing Address - Phone:512-230-8846
Mailing Address - Fax:
Practice Address - Street 1:106 E 16TH ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6904
Practice Address - Country:US
Practice Address - Phone:224-543-6292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional