MEDICARE: EMBRACE WELLNESS BEHAVIORAL HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1164356515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBRACE WELLNESS BEHAVIORAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	187 STATE ST # 1
Second Line	:
City	:	PRESQUE ISLE
State	:	ME
Zip	:	04769-2683
Country	:	US
Telephone Number	:	207-380-4512
Fax Number	:

Provider Business Practice Location Address
First Line	:	187 STATE ST FL 4
Second Line	:
City	:	PRESQUE ISLE
State	:	ME
Zip	:	04769-2683
Country	:	US
Telephone Number	:	207-380-4512
Fax Number	:

Authorized Official
Title or Position	:	PMHNP
Name	:	MEGAN CLARK
Credential	:	MSN APRN PMHNP-BC
Telephone Number	:	207-380-4512

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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