Provider Demographics
NPI:1932685732
Name:EMERY, KIRSTEN ANN (MS, LMFT, CADC)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:ANN
Last Name:EMERY
Suffix:
Gender:F
Credentials:MS, LMFT, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 WHEATON OAKS CT
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-3181
Mailing Address - Country:US
Mailing Address - Phone:630-940-6828
Mailing Address - Fax:
Practice Address - Street 1:1131 WHEATON OAKS CT
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3181
Practice Address - Country:US
Practice Address - Phone:630-940-6828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-14
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL34671101YA0400X
IL208.000530101YM0800X
IL166.001243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)