Provider Demographics
NPI:1730665001
Name:WILLET, EMILY (MA, LMHC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WILLET
Suffix:
Gender:F
Credentials:MA, LMHC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 W RIVERSIDE AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1099
Mailing Address - Country:US
Mailing Address - Phone:509-290-1525
Mailing Address - Fax:509-204-5942
Practice Address - Street 1:905 W RIVERSIDE AVE STE 214
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1099
Practice Address - Country:US
Practice Address - Phone:509-290-1525
Practice Address - Fax:509-204-5942
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-6447101YP2500X
WALH60820517101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2105320Medicaid