Provider Demographics
NPI:1750461356
Name:EMMETT, MICHELE KATHRYN (LCPC/ LPC)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:KATHRYN
Last Name:EMMETT
Suffix:
Gender:F
Credentials:LCPC/ LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 E GRANT ST
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-1015
Mailing Address - Country:US
Mailing Address - Phone:717-597-5037
Mailing Address - Fax:301-790-9674
Practice Address - Street 1:580 NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2847
Practice Address - Country:US
Practice Address - Phone:301-791-9760
Practice Address - Fax:301-791-9674
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCO 656101YP2500X
PAPC000956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional