Provider Demographics
NPI:1205561156
Name:EMBOLDEN THERAPEUTIC SOLUTIONS LLC
Entity type:Organization
Organization Name:EMBOLDEN THERAPEUTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:908-409-1664
Mailing Address - Street 1:100 VILLAGE CT STE 202A
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1565
Mailing Address - Country:US
Mailing Address - Phone:908-409-1664
Mailing Address - Fax:
Practice Address - Street 1:100 VILLAGE CT STE 202A
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1548
Practice Address - Country:US
Practice Address - Phone:908-409-1664
Practice Address - Fax:732-790-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty