Provider Demographics
NPI:1720408537
Name:WINESBERRY, EMILY LOUISE (LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LOUISE
Last Name:WINESBERRY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N BROADWAY AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-2301
Mailing Address - Country:US
Mailing Address - Phone:510-842-6697
Mailing Address - Fax:
Practice Address - Street 1:200 N BROADWAY AVE FL 5
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2301
Practice Address - Country:US
Practice Address - Phone:510-842-6697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119012106H00000X
KS03142106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist