Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Emily Jeanne Fornwalt, LCMHC-S

Individual provider Mental Health Counselor · NPI 1083745434

Emily Jeanne Fornwalt, LCMHC-S is a Mental Health Counselor in Johnson City, Tennessee. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2007

Practice location Address checks out

614 W Pine St
Johnson City, TN 37604-6608
Phone: (423) 281-4089
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence S6459 (NC)

Record details

NPI number1083745434
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCMHC-S
Sole proprietorYes
NPI enumeratedMarch 8, 2007
Last updated in NPPESMay 1, 2024
Certification dateMay 1, 2024

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