Healthcare Provider Details

I. General information

NPI: 1316283211
Provider Name (Legal Business Name): EMILY HERBER MCLEAN MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2012
Last Update Date: 11/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 LEOPARD RD EXECUTIVE GREEN I SUITE 304
PAOLI PA
19301-1549
US

IV. Provider business mailing address

340 BRIDGE ST
COLLEGEVILLE PA
19426-3504
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-4873
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number007071
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: