Provider Demographics
NPI:1942061478
Name:FUTRELL, EMILEE (LCMHCA)
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:
Last Name:FUTRELL
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 HAWTHORNE LN APT 207
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-2992
Mailing Address - Country:US
Mailing Address - Phone:252-289-0260
Mailing Address - Fax:
Practice Address - Street 1:4501 MINT HILL VILLAGE LANE
Practice Address - Street 2:SUITE 204
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227
Practice Address - Country:US
Practice Address - Phone:704-286-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19589101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor