Provider Demographics
NPI:1598991580
Name:HARRELL, EMILY (LMFT, LPC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HARRELL
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W FULLERTON PKWY
Mailing Address - Street 2:APT. 301W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2870
Mailing Address - Country:US
Mailing Address - Phone:312-813-7700
Mailing Address - Fax:
Practice Address - Street 1:875 N MICHIGAN AVE
Practice Address - Street 2:SUITE 3100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1803
Practice Address - Country:US
Practice Address - Phone:312-813-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.005553101YM0800X
IL166.000773106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health