Provider Demographics
NPI:1568092864
Name:WOOLDRIDGE, EMILY ELYSE WHITE (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ELYSE WHITE
Last Name:WOOLDRIDGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1034
Mailing Address - Street 2:
Mailing Address - City:PISGAH FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:28768-1034
Mailing Address - Country:US
Mailing Address - Phone:828-545-0984
Mailing Address - Fax:
Practice Address - Street 1:26 E MAIN ST STE 8
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3760
Practice Address - Country:US
Practice Address - Phone:828-545-0984
Practice Address - Fax:828-519-5002
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0111911041C0700X
NC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical