Provider Demographics
NPI:1598045551
Name:WILSON, EMILY NICOLE (LPC, LMFT, CRC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:WILSON
Suffix:
Gender:F
Credentials:LPC, LMFT, CRC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:NICOLE
Other - Last Name:DOWNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LMFT
Mailing Address - Street 1:403 WEST OAK STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730
Mailing Address - Country:US
Mailing Address - Phone:870-639-4527
Mailing Address - Fax:318-841-2800
Practice Address - Street 1:403 WEST OAK STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730
Practice Address - Country:US
Practice Address - Phone:870-639-4527
Practice Address - Fax:318-841-2800
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3129101YP2500X
MECC6862101YP2500X
LA1114106H00000X
ARP2005007101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist