Provider Demographics
NPI:1508209537
Name:WEIS, EMILY (LPC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WEIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:VANDERHOOF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:108 E YORK ST STE 218
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-3719
Mailing Address - Country:US
Mailing Address - Phone:912-600-4322
Mailing Address - Fax:
Practice Address - Street 1:108 E YORK ST STE 218
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-3719
Practice Address - Country:US
Practice Address - Phone:912-600-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional