Provider Demographics
NPI:1215246681
Name:MARTINDALE, EMERY SCOTT (LPC)
Entity type:Individual
Prefix:MR
First Name:EMERY
Middle Name:SCOTT
Last Name:MARTINDALE
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 1:2300 VALLEY VIEW LN
Mailing Address - Street 2:SUITE 400
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-1721
Mailing Address - Country:US
Mailing Address - Phone:972-955-0502
Mailing Address - Fax:
Practice Address - Street 1:2300 VALLEY VIEW LN
Practice Address - Street 2:SUITE 400
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-1721
Practice Address - Country:US
Practice Address - Phone:972-955-0502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66863101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor