Provider Demographics
NPI:1174785893
Name:EMMONS, BETH L (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:L
Last Name:EMMONS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:E
Other - Last Name:LAWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:4100 GREENBRIAR ST
Mailing Address - Street 2:#564
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5200
Mailing Address - Country:US
Mailing Address - Phone:206-218-9571
Mailing Address - Fax:
Practice Address - Street 1:726 W 17TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3526
Practice Address - Country:US
Practice Address - Phone:206-218-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX590711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical