Embracing Life Changes Thru Counseling, LLC
Organization Active NPI Professional Counselor · Aberdeen, NJ
NPI 1093549099 · NPPES record last updated Jan 8, 2025
Key facts
- NPI
- 1093549099
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- Legal business name
- EMBRACING LIFE CHANGES THRU COUNSELING, LLC
- Practice address
- 6 2ND St
Aberdeen, NJ 07747-2312 - Phone
- (732) 744-4406
- Fax
- (732) 307-8036
- NPI assigned
- Aug 30, 2024
- Organization subpart
- No
Authorized official
- Name
- Ms. Pennie L. Colleton, LPC
- Title
- Mental Health Therapist
- Phone
- (732) 744-4406
Practitioners 1
-
Pennie L. Colleton, NCC, LPC, LCADC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241112004474 | NJ | Part B Supplier - Clinic/Group Practice | 5496289514 |
Receives reassigned benefits from 1 practitioner Practice locations: Aberdeen, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Professional Counselor |
101YP2500X | Yes |
Addresses
Primary practice location
6 2ND St
Aberdeen, NJ 07747-2312
Mailing address
6 2ND St
Aberdeen, NJ 07747-2312
Phone (732) 744-4406
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1054163 | Medicaid | NJ |
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All providers in Aberdeen, NJ · Professional Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.