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General NPI Number Information
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NPI Number | 1770850844
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Entity Type | Individual
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Provider Name | EMILY NAMASTE HALLIDAY LCPC
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Gender | Female
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 636 CHURCH ST SUITE 515
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City | EVANSTON
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State | IL
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Zip | 60201-4508
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Country | US
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Telephone | 847-899-0315
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Fax |
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Provider Business Mailing Address
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Address Line | 636 CHURCH ST SUITE 515
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City | EVANSTON
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State | IL
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Zip | 60201-4508
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Country | US
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Telephone | 847-899-0315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178007666
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180009240
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License Number State | IL
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