Basic Information
| Provider Information | |||||||||
| NPI: | 1780984864 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TEMPLETON | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14205 N MOPAC | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787286527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122751285 | ||||||||
| FaxNumber: | 2107337118 | ||||||||
| Practice Location | |||||||||
| Address1: | 14205 N MOPAC | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787286527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122751285 | ||||||||
| FaxNumber: | 2107337118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2010 | ||||||||
| LastUpdateDate: | 10/23/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 19438 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 74-2631080 | 05 | TX | MEDICAID |