=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356794671
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMBARK COUNSELING SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2016
-----------------------------------------------------
Last Update Date | 09/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5001 COLLEGE BLVD STE 105
-----------------------------------------------------
City | LEAWOOD
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66211-1618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-257-3161
-----------------------------------------------------
Fax | 888-965-8977
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5001 COLLEGE BLVD STE 105
-----------------------------------------------------
City | LEAWOOD
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66211-1618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-257-3161
-----------------------------------------------------
Fax | 888-965-8977
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | TERESA PATERSON BARTCH
-----------------------------------------------------
Credential | LPC, LCPC
-----------------------------------------------------
Telephone | 913-257-3161
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 2606
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 2014015305
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------