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Individual

EMILY DERBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC, LPC

Contact information

Practice address
1443 HARTFORD AVE, JOHNSTON, RI 02919-3224
(401) 273-8100
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00693
RI
101YP2500X
Professional Counselor
LPC.0016171
CO

Other

Enumeration date
03/31/2015
Last updated
05/01/2022
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