| Embodied Mental Health Counseling Llc | |
|
127 W Berry St Ste 311 Fort Wayne IN 46802-2310 | |
| (260) 440-1001 | |
| Not Available |
| Full Name | Embodied Mental Health Counseling Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 127 W Berry St Ste 311, Fort Wayne, Indiana |
| Authorized Official Name and Position | Shelby Layne (OWNER) |
| Authorized Official Contact | 2604401001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Embodied Mental Health Counseling Llc 127 W Berry St Ste 311 Fort Wayne IN 46802-2310 Ph: (260) 440-1001 | Embodied Mental Health Counseling Llc 127 W Berry St Ste 311 Fort Wayne IN 46802-2310 Ph: (260) 440-1001 |
| NPI Number | 1013734714 |
|---|---|
| Provider Enumeration Date | 09/24/2024 |
| Last Update Date | 09/24/2024 |
| Certification Date | 09/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013734714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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