Provider Demographics
NPI:1821722885
Name:EHMAN, MACEY (LPC)
Entity Type:Individual
Prefix:
First Name:MACEY
Middle Name:
Last Name:EHMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 OLD FEDERAL RD
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:TN
Mailing Address - Zip Code:37361-3210
Mailing Address - Country:US
Mailing Address - Phone:478-231-3941
Mailing Address - Fax:
Practice Address - Street 1:1590 OLD FEDERAL RD
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:TN
Practice Address - Zip Code:37361-3210
Practice Address - Country:US
Practice Address - Phone:478-231-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222579101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional