Healthcare Provider Details

I. General information

NPI: 1861109316
Provider Name (Legal Business Name): EMBRACE COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 BARRETT DR
RALEIGH NC
27609-6625
US

IV. Provider business mailing address

2013 BALLSTON PL
KNIGHTDALE NC
27545-7439
US

V. Phone/Fax

Practice location:
  • Phone: 919-302-3274
  • Fax:
Mailing address:
  • Phone: 919-302-3274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD HOGGARD JR.
Title or Position: THERAPIST
Credential: LCSW
Phone: 919-302-3274