Healthcare Provider Details

I. General information

NPI: 1194092833
Provider Name (Legal Business Name): EMILY BURROWS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY MELVIN

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3248 VANDEVER AVE
PEKIN IL
61554-6257
US

IV. Provider business mailing address

1802 N DIVISION ST STE 509
MORRIS IL
60450-3107
US

V. Phone/Fax

Practice location:
  • Phone: 309-347-5579
  • Fax: 309-347-7302
Mailing address:
  • Phone: 815-941-3882
  • Fax: 815-941-3884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: