Provider Demographics
NPI:1205573110
Name:WHITCOMB, EMMA THERESE (LMFT)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:THERESE
Last Name:WHITCOMB
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30937 W PICADILLY RD
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-6853
Mailing Address - Country:US
Mailing Address - Phone:470-454-0451
Mailing Address - Fax:
Practice Address - Street 1:6424 E GREENWAY PKWY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2045
Practice Address - Country:US
Practice Address - Phone:470-454-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001917106H00000X
AZLMFT-7376T106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist