Provider Demographics
NPI:1720413487
Name:EMHARDT, KELSEY ALINA (LPC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ALINA
Last Name:EMHARDT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KELYSEY
Other - Middle Name:ALINA
Other - Last Name:SCHROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:9983 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9297
Mailing Address - Country:US
Mailing Address - Phone:724-935-1555
Mailing Address - Fax:
Practice Address - Street 1:9983 PERRY HWY
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9297
Practice Address - Country:US
Practice Address - Phone:724-935-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY90574101YM0800X
PAPC009062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health