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Organization

EMBODIED PRACTICE THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RACHEL E HUDGENS LCSW (CLINICAL SOCIAL WORKER)
(847) 868-4585
Entity
Organization

Contact information

Practice address
751 SHERMAN AVE APT 3, EVANSTON, IL 60202-4357
(845) 886-4585
Mailing address
751 SHERMAN AVE APT 3, EVANSTON, IL 60202-4357

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
07/22/2022
Last updated
07/03/2023
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