Provider Demographics
NPI:1093424988
Name:EMBRACE MENTAL HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:EMBRACE MENTAL HEALTH & WELLNESS LLC
Other - Org Name:EMBRACE MENTAL HEALTH & WELLNESS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY-POPE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:804-615-5118
Mailing Address - Street 1:10221 KRAUSE RD UNIT 2188
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-1288
Mailing Address - Country:US
Mailing Address - Phone:804-615-5118
Mailing Address - Fax:
Practice Address - Street 1:9844 LORI RD STE 101
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6691
Practice Address - Country:US
Practice Address - Phone:804-615-5118
Practice Address - Fax:804-207-8831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty