Provider Demographics
NPI:1609558782
Name:EMBRACE THERAPY & FITNESS
Entity Type:Organization
Organization Name:EMBRACE THERAPY & FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHULER-GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:803-747-2899
Mailing Address - Street 1:1855 E MAIN ST STE 14 #252
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307
Mailing Address - Country:US
Mailing Address - Phone:864-209-1522
Mailing Address - Fax:
Practice Address - Street 1:414 DELLWATER WAY
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-5904
Practice Address - Country:US
Practice Address - Phone:803-747-2899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty