Provider Demographics
NPI:1881340412
Name:EMBRACING OUR JOURNEY COUNSELING, LLC
Entity type:Organization
Organization Name:EMBRACING OUR JOURNEY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:147-521-8310
Mailing Address - Street 1:365 ALLENTOWN RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-1606
Mailing Address - Country:US
Mailing Address - Phone:475-218-3107
Mailing Address - Fax:
Practice Address - Street 1:225 N MAIN ST STE 312
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4993
Practice Address - Country:US
Practice Address - Phone:475-218-3107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)