Provider Demographics
NPI:1194272971
Name:EMERY, WILLIAM L (LPC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:EMERY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3789 BLESSING AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-6535
Mailing Address - Country:US
Mailing Address - Phone:907-488-2825
Mailing Address - Fax:
Practice Address - Street 1:3789 BLESSING AVE
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-6535
Practice Address - Country:US
Practice Address - Phone:907-488-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK99174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist