Provider Demographics
NPI:1831873975
Name:FLINT, EMILY K (LPC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:FLINT
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 1:11029 W SOLUNA DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-8010
Mailing Address - Country:US
Mailing Address - Phone:208-871-0926
Mailing Address - Fax:
Practice Address - Street 1:5230 W MOONLIGHT MINE RD
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-9013
Practice Address - Country:US
Practice Address - Phone:208-505-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-9563101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty