Healthcare Provider Details

I. General information

NPI: 1255089454
Provider Name (Legal Business Name): EMBRACE CONNECTION COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3637 STATE ROUTE 5 STE 3
CORTLAND OH
44410-1651
US

IV. Provider business mailing address

3637 STATE ROUTE 5 STE 3
CORTLAND OH
44410-1651
US

V. Phone/Fax

Practice location:
  • Phone: 330-756-7695
  • Fax: 330-913-0594
Mailing address:
  • Phone: 330-756-7695
  • Fax: 330-913-0594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANNA BREWER
Title or Position: OWNER
Credential: LISW
Phone: 234-600-1483