Provider Demographics
NPI:1992127294
Name:EMBRACING YOU COUNSELING SERVICES INC
Entity type:Organization
Organization Name:EMBRACING YOU COUNSELING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTIONE
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-953-4612
Mailing Address - Street 1:540 NW 165TH STREET RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6304
Mailing Address - Country:US
Mailing Address - Phone:786-953-4612
Mailing Address - Fax:786-953-8534
Practice Address - Street 1:540 NW 165TH STREET RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6304
Practice Address - Country:US
Practice Address - Phone:786-953-4612
Practice Address - Fax:786-953-8534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013586500Medicaid