Provider Demographics
NPI:1174169098
Name:VASSEUR, EMILY ANN (MS, LCPC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:VASSEUR
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 WOODMONT AVE STE 840
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2789
Mailing Address - Country:US
Mailing Address - Phone:802-279-8039
Mailing Address - Fax:240-623-9858
Practice Address - Street 1:8120 WOODMONT AVE STE 840
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2789
Practice Address - Country:US
Practice Address - Phone:802-279-8039
Practice Address - Fax:240-623-9858
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9695101YM0800X
MDLC11644101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health