Embodied Therapy PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

EMBODIED THERAPY PLLC

Practice address

4020 Oleander Dr Ste 203
Wilmington, NC 28403-6850

Phone

(910) 262-9044

NPI assigned

Dec 27, 2022

Organization subpart

No

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

Authorized official

Name

Paula Jean Ackermann, LCSWNPI 1922473594

Title

Owner

Phone

(910) 262-9044

Specialties & licenses 1

Addresses

Other names 1

• Embodied Therapy PLLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paula Jean Ackermann, LCSWA

  • Clinical Social Worker
  • Wilmington, NC
  • NPI 1922473594
  NPD Authorized official

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1396458055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 MIDLAND DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126516",
            "telephone_number": "910-262-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 OLEANDER DR STE 203",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036850",
            "telephone_number": "910-262-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODIED THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "ACKERMANN",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-262-9044",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embodied Therapy PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Allen Ellsworth, LCMHCA
• Stacia Leigh Ellsworth, LCMHC
• Erin Amber Elphick, PA-C
• Camryn L Elswick, LCSWA
• Embark Counseling NC, PLLC
• Embrace Wellness Coastal Group, LLC
• Emerge Counseling Center
• Emergeortho PA
• Emergeortho, P.a.
• Emergeortho, P.a.

• Adult Mental Health Clinic/Center in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.