Provider Demographics
NPI:1568733210
Name:HERVEY, EMILEE GRIFFIN (LPC INTERN)
Entity Type:Individual
Prefix:MRS
First Name:EMILEE
Middle Name:GRIFFIN
Last Name:HERVEY
Suffix:
Gender:F
Credentials:LPC INTERN
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:
Other - Last Name:HERVEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1701 N GREENVILLE AVE
Mailing Address - Street 2:STE. 700
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6707
Mailing Address - Country:US
Mailing Address - Phone:972-201-3250
Mailing Address - Fax:
Practice Address - Street 1:1701 N GREENVILLE AVE
Practice Address - Street 2:STE. 700
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6707
Practice Address - Country:US
Practice Address - Phone:972-201-3250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67650101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional