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NPI Code Detail

MEDICARE: EMMA JEAN MCEVILLY LMHC

MEDICARE: EMMA JEAN MCEVILLY LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor39006048AIN

General Provider Information

NPI Number : 1043141625
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA JEAN MCEVILLY LMHC
Provider Business Mailing Address
First Line : 820 W COUNTRY CLUB DR
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-4312
Country : US
Telephone Number : 812-360-7401
Fax Number :
Provider Business Practice Location Address
First Line : 4307 S LEONARD SPRINGS RD
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-4078
Country : US
Telephone Number : 812-223-7186
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2026
Last Update Date : 05/25/2026

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