Provider Demographics
NPI:1710690649
Name:SCHWARTZ, MYLISSA JOY
Entity Type:Individual
Prefix:
First Name:MYLISSA
Middle Name:JOY
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EMBRIDGE COUNSELING SERVICES, LLC
Mailing Address - Street 2:140 S. BEACH STREET, SUITE 310
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4409
Mailing Address - Country:US
Mailing Address - Phone:631-678-1359
Mailing Address - Fax:
Practice Address - Street 1:EMBRIDGE COUNSELING SERVICES, LLC
Practice Address - Street 2:140 S. BEACH STREET, SUITE 310
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4409
Practice Address - Country:US
Practice Address - Phone:631-678-1359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health