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NPI Code Detail

MEDICARE: EMBODIED LIVING COUNSELING, LLC

MEDICARE: EMBODIED LIVING COUNSELING, LLC
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 Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942804885
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMBODIED LIVING COUNSELING, LLC
Provider Business Mailing Address
First Line : 39 NICHOLS RD
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-2031
Country : US
Telephone Number : 401-258-4437
Fax Number :
Provider Business Practice Location Address
First Line : 1130 TEN ROD RD STE E204
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-4168
Country : US
Telephone Number : 401-258-4437
Fax Number : 401-386-3443
Authorized Official
Title or Position : OWNER
Name : CHELSEA STOREY HILL
Credential : LICSW
Telephone Number : 401-258-4437
Provider Enumeration Date : 11/22/2020
Last Update Date : 11/23/2020

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Directions to “EMBODIED LIVING COUNSELING, LLC ” Practice Location

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