Provider Demographics
NPI:1013457951
Name:EMBRACE THE CENTER FOR EMOTIONAL WELLBEING LLC
Entity Type:Organization
Organization Name:EMBRACE THE CENTER FOR EMOTIONAL WELLBEING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:827-216-7793
Mailing Address - Street 1:4305 N LINCOLN AVE
Mailing Address - Street 2:STE M
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-1807
Mailing Address - Country:US
Mailing Address - Phone:824-216-7793
Mailing Address - Fax:855-727-4855
Practice Address - Street 1:4305 N LINCOLN AVE
Practice Address - Street 2:STE M
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1807
Practice Address - Country:US
Practice Address - Phone:824-216-7793
Practice Address - Fax:855-727-4855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-25
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009049103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty