Provider Demographics
NPI:1962946228
Name:EMBRACING LIFE COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:EMBRACING LIFE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ROME
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:504-292-9291
Mailing Address - Street 1:4147 COPERNICUS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-3415
Mailing Address - Country:US
Mailing Address - Phone:504-292-9291
Mailing Address - Fax:504-229-6745
Practice Address - Street 1:2372 SAINT CLAUDE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-8351
Practice Address - Country:US
Practice Address - Phone:504-292-9291
Practice Address - Fax:504-229-6745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4913101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty