Provider Demographics
NPI:1437809076
Name:KELLY, EMILY (LPC-ASSOCIATE)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:KELLY
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 MISTY HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5966
Mailing Address - Country:US
Mailing Address - Phone:313-460-2232
Mailing Address - Fax:
Practice Address - Street 1:5465 LEGACY DR STE 650
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3190
Practice Address - Country:US
Practice Address - Phone:469-573-1109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-26
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83825101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional