Provider Demographics
NPI:1467800359
Name:TODD, EMMA KENNEDY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:KENNEDY
Last Name:TODD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:EMMA
Other - Middle Name:KENNEDY
Other - Last Name:CLANCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7204 SKYWAY
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-3280
Mailing Address - Country:US
Mailing Address - Phone:530-877-1965
Mailing Address - Fax:
Practice Address - Street 1:6 GOVERNORS LN STE A
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-5590
Practice Address - Country:US
Practice Address - Phone:530-366-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA932911041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker