Provider Demographics
NPI:1447671599
Name:BILL, EMILY BETTY (LPCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BETTY
Last Name:BILL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:BETTY
Other - Last Name:KRANSBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2417 MARSHALL RD STE 1
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-9401
Mailing Address - Country:US
Mailing Address - Phone:760-355-0161
Mailing Address - Fax:
Practice Address - Street 1:2417 MARSHALL RD STE 1
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-9401
Practice Address - Country:US
Practice Address - Phone:760-355-0161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC 315101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health