Healthcare Provider Details

I. General information

NPI: 1144156068
Provider Name (Legal Business Name): EMBODIED WITH ANNA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65-1225 HOKUULA RD
KAMUELA HI
96743-8323
US

IV. Provider business mailing address

65-1225 HOKUULA RD
KAMUELA HI
96743-8323
US

V. Phone/Fax

Practice location:
  • Phone: 610-308-8439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANNA HERMAN
Title or Position: PRESIDENT
Credential: LPC, LMHC, LCPC
Phone: 610-308-8439