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General NPI Number Information
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NPI Number | 1235914540
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Entity Type | Organization
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Legal Business Name | MAGGIE EMBICK LCSW LLC
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 412A MALUNIU AVE
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City | KAILUA
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State | HI
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Zip | 96734-5815
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Country | US
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Telephone | 312-883-3996
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Fax |
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Provider Business Mailing Address
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Address Line | 412A MALUNIU AVE
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City | KAILUA
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State | HI
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Zip | 96734-5815
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Country | US
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Telephone | 312-883-3996
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICAL THERAPIST
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Name | MARGARET EMBICK
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Credential | LCSW, RDT
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Telephone | 312-883-3996
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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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