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NPI Code Detail

MEDICARE: MS. EMMA CAROLINE MATTINGLY M.ED., LPCC

MEDICARE: MS. EMMA CAROLINE MATTINGLY M.ED., LPCC
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
1101Y00000XCounselor246314KY

General Provider Information

NPI Number : 1326606559
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EMMA CAROLINE MATTINGLY M.ED., LPCC
Provider Business Mailing Address
First Line : 3515 FOREST CIR
Second Line :
City : PADUCAH
State : KY
Zip : 42001-4434
Country : US
Telephone Number : 270-519-5984
Fax Number :
Provider Business Practice Location Address
First Line : 2500 HOLT RD
Second Line :
City : PADUCAH
State : KY
Zip : 42001-8661
Country : US
Telephone Number : 270-681-2469
Fax Number : 270-721-4111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2019
Last Update Date : 09/20/2021

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