Healthcare Provider Details

I. General information

NPI: 1174476451
Provider Name (Legal Business Name): EMILY EDMUNDSON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 BEECH ST
VALPARAISO IN
46383-6106
US

IV. Provider business mailing address

2401 BEECH ST
VALPARAISO IN
46383-6106
US

V. Phone/Fax

Practice location:
  • Phone: 219-688-8278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39005891A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: