Provider Demographics
NPI:1659706240
Name:WALLACE, EMILY MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:WALLACE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MARIE
Other - Last Name:ABRUZZESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 RUSSELL STREET
Mailing Address - Street 2:NEW ENGLAND CENTER FOR MENTAL HEALTH
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460
Mailing Address - Country:US
Mailing Address - Phone:978-856-4938
Mailing Address - Fax:
Practice Address - Street 1:119 RUSSELL STREET
Practice Address - Street 2:NEW ENGLAND CENTER FOR MENTAL HEALTH
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-3076
Practice Address - Country:US
Practice Address - Phone:978-679-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health