Provider Demographics
NPI:1790583052
Name:LILES, EMMA L (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:L
Last Name:LILES
Suffix:
Gender:
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E COTTON ST STE 700
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75602-1514
Mailing Address - Country:US
Mailing Address - Phone:903-500-2005
Mailing Address - Fax:
Practice Address - Street 1:2000 E COTTON ST STE 700
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75602-1514
Practice Address - Country:US
Practice Address - Phone:903-500-2005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty