Provider Demographics
NPI:1699521872
Name:EMBRACE SELF LOVE THERAPY
Entity type:Organization
Organization Name:EMBRACE SELF LOVE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:HADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-702-9307
Mailing Address - Street 1:250 W JUNIPER AVE UNIT 56
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3939
Mailing Address - Country:US
Mailing Address - Phone:952-737-2420
Mailing Address - Fax:
Practice Address - Street 1:3295 N DRINKWATER BLVD STE 10
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6437
Practice Address - Country:US
Practice Address - Phone:602-702-9307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty