| Embrace Counseling Services, Llc | |
|
3524 Brambleton Ave Suite 2 Roanoke VA 24018-6528 | |
| (540) 819-4353 | |
| Not Available |
| Full Name | Embrace Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 3524 Brambleton Ave, Roanoke, Virginia |
| Authorized Official Name and Position | Shana Jackson (OWNER/COUNSELOR) |
| Authorized Official Contact | 5408194353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Embrace Counseling Services, Llc 3524 Brambleton Ave Suite 2 Roanoke VA 24018-6528 Ph: (540) 819-4353 | Embrace Counseling Services, Llc 3524 Brambleton Ave Suite 2 Roanoke VA 24018-6528 Ph: (540) 819-4353 |
| NPI Number | 1184150781 |
|---|---|
| Provider Enumeration Date | 05/03/2017 |
| Last Update Date | 05/03/2017 |
| Medicare PECOS PAC ID | 8729315643 |
|---|---|
| Medicare Enrollment ID | O20190814002848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184150781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0904009062 (Virginia) | Primary |
| Provider Name | Shane Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639552094 PECOS PAC ID: 6709113624 Enrollment ID: I20190814003020 |
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