Healthcare Provider Details

I. General information

NPI: 1124756887
Provider Name (Legal Business Name): EMBRACE WELLNESS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 N LOCUST ST
LITITZ PA
17543-1716
US

IV. Provider business mailing address

15 N LOCUST ST
LITITZ PA
17543-1716
US

V. Phone/Fax

Practice location:
  • Phone: 717-853-1964
  • Fax:
Mailing address:
  • Phone: 717-853-1964
  • Fax: 717-670-9136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAUREN BAKER
Title or Position: LCSW
Credential: LCSW
Phone: 610-314-1672