Provider Demographics
NPI:1730554643
Name:EMERY, ANNETTE (LCSW)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:EMERY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 E HWY 290
Mailing Address - Street 2:SUITE 212
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6633 E HWY 290
Practice Address - Street 2:SUITE 212
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1172
Practice Address - Country:US
Practice Address - Phone:832-687-5593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical