Provider Demographics
NPI:1902022528
Name:EMBERLEY, PATRICIA PIERCE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:PIERCE
Last Name:EMBERLEY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HAYDEN RDG
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2528
Mailing Address - Country:US
Mailing Address - Phone:248-880-8041
Mailing Address - Fax:
Practice Address - Street 1:16 HAYDEN RDG
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:248-880-8041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014812101YP2500X
TX17146101YP2500X
ORC1344101YP2500X
CAMFC 41748106H00000X
MI4101006642106H00000X
MA10620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist