Provider Demographics
NPI:1467827279
Name:EMMECK, MARY ELLEN (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELLEN
Last Name:EMMECK
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
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Mailing Address - Street 1:8401 WAYZATA BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1377
Mailing Address - Country:US
Mailing Address - Phone:763-226-3808
Mailing Address - Fax:763-544-1008
Practice Address - Street 1:8401 WAYZATA BLVD STE 150
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1377
Practice Address - Country:US
Practice Address - Phone:763-544-1006
Practice Address - Fax:763-544-1008
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health