Embrace Counseling Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0904009062 Issued in VA

Legal business name

EMBRACE COUNSELING SERVICES, LLC

Practice address

3524 Brambleton Ave
Suite 2
Roanoke, VA 24018-6528

Phone

(540) 819-4353

NPI assigned

May 3, 2017

Last updated

May 3, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shana Jackson, LCSWNPI 1639552094

Title

Owner/Counselor

Phone

(540) 819-4353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shana Jackson, LCSW

  • Clinical Social Worker
  • Roanoke, VA
  • NPI 1639552094
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493769600000",
    "number": "1184150781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 BRAMBLETON AVE",
            "address_2": "SUITE 2",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186528",
            "telephone_number": "540-819-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 BRAMBLETON AVE",
            "address_2": "SUITE 2",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186528",
            "telephone_number": "540-819-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBRACE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2017-05-03",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "540-819-4353",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904009062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.