Provider Demographics
NPI:1053071001
Name:EMBRACE YOUR JOURNEY COUNSELING LLC
Entity Type:Organization
Organization Name:EMBRACE YOUR JOURNEY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCA
Authorized Official - Phone:859-279-2003
Mailing Address - Street 1:107 WARFIELD PT
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-6148
Mailing Address - Country:US
Mailing Address - Phone:859-279-2003
Mailing Address - Fax:
Practice Address - Street 1:513 DARBY CREEK ROAD
Practice Address - Street 2:SUITE 56
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509
Practice Address - Country:US
Practice Address - Phone:859-279-2003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty