Provider Demographics
NPI:1801223383
Name:EMERSON, KEISHA ALLIE (MA, LCAS, LCMHC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:KEISHA
Middle Name:ALLIE
Last Name:EMERSON
Suffix:
Gender:F
Credentials:MA, LCAS, LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 963
Mailing Address - Street 2:
Mailing Address - City:DREXEL
Mailing Address - State:NC
Mailing Address - Zip Code:28619-0963
Mailing Address - Country:US
Mailing Address - Phone:828-448-5413
Mailing Address - Fax:
Practice Address - Street 1:117 FOOTHILLS DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5152
Practice Address - Country:US
Practice Address - Phone:828-580-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health