Provider Demographics
NPI:1194275065
Name:EMBRACE COUNSELING SERVICES
Entity type:Organization
Organization Name:EMBRACE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WALEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LICSW, CEDS
Authorized Official - Phone:410-299-2272
Mailing Address - Street 1:9192 RED BRANCH RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2030
Mailing Address - Country:US
Mailing Address - Phone:877-651-1841
Mailing Address - Fax:877-651-1841
Practice Address - Street 1:9192 RED BRANCH RD
Practice Address - Street 2:SUITE 270
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2030
Practice Address - Country:US
Practice Address - Phone:877-651-1841
Practice Address - Fax:877-651-1841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty