Provider Demographics
NPI:1063851178
Name:EMMONS, KRISTI MICHELLE (LPC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:MICHELLE
Last Name:EMMONS
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 1:5511 STAPLES MILL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-5445
Mailing Address - Country:US
Mailing Address - Phone:804-612-3322
Mailing Address - Fax:804-864-1323
Practice Address - Street 1:5511 STAPLES MILL RD STE 102
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-5445
Practice Address - Country:US
Practice Address - Phone:804-612-3322
Practice Address - Fax:804-864-1323
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005395101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional