Provider Demographics
NPI:1457819393
Name:FEESE, EMILY G (LMHP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:G
Last Name:FEESE
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:G
Other - Last Name:SPARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-5805
Mailing Address - Country:US
Mailing Address - Phone:308-675-3345
Mailing Address - Fax:
Practice Address - Street 1:707 W 1ST ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-5805
Practice Address - Country:US
Practice Address - Phone:308-675-3345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1667101YA0400X
NE5929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)