Provider Demographics
NPI:1932690302
Name:EMBRACE HOPE COUNSELING, LLC
Entity Type:Organization
Organization Name:EMBRACE HOPE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:920-750-6132
Mailing Address - Street 1:5497 W WATERFORD LN STE A
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8489
Mailing Address - Country:US
Mailing Address - Phone:920-750-6132
Mailing Address - Fax:920-750-6121
Practice Address - Street 1:5497 W WATERFORD LN STE A
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8489
Practice Address - Country:US
Practice Address - Phone:920-750-6132
Practice Address - Fax:920-750-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)