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General NPI Number Information
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NPI Number | 1215648258
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Entity Type | Organization
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Legal Business Name | EMBRACE IT COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 503 S URBANA AVE APT D
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City | URBANA
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State | IL
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Zip | 61801-4266
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Country | US
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Telephone | 872-903-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 907 W MARKETVIEW DR STE 10
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City | CHAMPAIGN
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State | IL
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Zip | 61822-1250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANDRA SLAYTON
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Credential | MS, LCPC
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Telephone | 872-903-3711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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