Healthcare Provider Details

I. General information

NPI: 1679423560
Provider Name (Legal Business Name): EMBARK COUNSELING & CONSULTATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7918 JONES BRANCH DR STE 400
MC LEAN VA
22102-3319
US

IV. Provider business mailing address

7918 JONES BRANCH DR STE 400
MC LEAN VA
22102-3319
US

V. Phone/Fax

Practice location:
  • Phone: 757-828-3832
  • 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: CHERELLE GOODE
Title or Position: OWNER
Credential: LPC
Phone: 757-828-3832