Healthcare Provider Details

I. General information

NPI: 1851106124
Provider Name (Legal Business Name): EMILY PHILLIPS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 S LORENZO AVE APT 2
TAMPA FL
33629-6296
US

IV. Provider business mailing address

9304 CAMDEN FIELD PKWY
RIVERVIEW FL
33578-0520
US

V. Phone/Fax

Practice location:
  • Phone: 813-541-2782
  • Fax:
Mailing address:
  • Phone: 813-533-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH22243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: