Provider Demographics
NPI:1588490593
Name:MCCAFFREY, EMILIE JORDYN (LPC, LPCA)
Entity type:Individual
Prefix:
First Name:EMILIE
Middle Name:JORDYN
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:LPC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11401 STAFFORDSBURG RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41051-7762
Mailing Address - Country:US
Mailing Address - Phone:859-912-4898
Mailing Address - Fax:
Practice Address - Street 1:7310 TURFWAY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1385
Practice Address - Country:US
Practice Address - Phone:859-715-1531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2304958101YP2500X
KY283720101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional