| Embodied Practice Therapy, Pllc | |
|
751 Sherman Ave Apt 3 Evanston IL 60202-4357 | |
| (845) 886-4585 | |
| Not Available |
| Full Name | Embodied Practice Therapy, Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 751 Sherman Ave Apt 3, Evanston, Illinois |
| Authorized Official Name and Position | Rachel E Hudgens (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8478684585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Embodied Practice Therapy, Pllc 751 Sherman Ave Apt 3 Evanston IL 60202-4357 Ph: () - | Embodied Practice Therapy, Pllc 751 Sherman Ave Apt 3 Evanston IL 60202-4357 Ph: (845) 886-4585 |
| NPI Number | 1568197531 |
|---|---|
| Provider Enumeration Date | 07/22/2022 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568197531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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