MEDICARE: EMBARK FAMILY THERAPY INC

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
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1174481675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBARK FAMILY THERAPY INC

Provider Business Mailing Address
First Line	:	2001 S BARRINGTON AVE STE 312
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5379
Country	:	US
Telephone Number	:	424-239-9616
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE STE 312
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5379
Country	:	US
Telephone Number	:	424-239-9616
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	WILLIAM MICHELSON
Credential	:	LMFT
Telephone Number	:	424-239-9616

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “EMBARK FAMILY THERAPY INC ” Practice Location

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