Provider Demographics
NPI:1679754493
Name:VONLETKEMANN, EMBER (LPC)
Entity type:Individual
Prefix:
First Name:EMBER
Middle Name:
Last Name:VONLETKEMANN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 SW TAYLOR ST STE 660
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2559
Mailing Address - Country:US
Mailing Address - Phone:503-347-0171
Mailing Address - Fax:
Practice Address - Street 1:1020 SW TAYLOR ST STE 660
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2559
Practice Address - Country:US
Practice Address - Phone:503-347-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health