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NPI Code Detail

MEDICARE: MR. MICHAEL EMBREY LCSW

MEDICARE:  MR. MICHAEL  EMBREY  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker090397NY
21041C0700XClinical Social Worker149.030629IL

General Provider Information

NPI Number : 1104569169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL EMBREY LCSW
Provider Business Mailing Address
First Line : PO BOX 746715
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6715
Country : US
Telephone Number : 773-352-1515
Fax Number : 312-929-0373
Provider Business Practice Location Address
First Line : 4747 N HARLEM AVE UNIT F2
Second Line :
City : HARWOOD HEIGHTS
State : IL
Zip : 60706-4666
Country : US
Telephone Number : 773-798-5200
Fax Number : 708-741-1014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2022
Last Update Date : 12/08/2025

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Directions to “ MR. MICHAEL EMBREY LCSW” Practice Location

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