Provider Demographics
NPI:1407510266
Name:TRIPP, EMILY SARAH (LMHC, MA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SARAH
Last Name:TRIPP
Suffix:
Gender:F
Credentials:LMHC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 2ND AVE NE STE 640
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3455
Mailing Address - Country:US
Mailing Address - Phone:727-344-9867
Mailing Address - Fax:
Practice Address - Street 1:111 2ND AVE NE STE 640
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3455
Practice Address - Country:US
Practice Address - Phone:727-344-9867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19148101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health