Emberlight Therapy LLC
Social Worker, Clinical in Mendota Heights, MN. Organization (NPI-2).
NPI number1538038468
StatusActive
Last updated in NPPESOct 30, 2025
Details
- NPI
- 1538038468
- Entity type
- Organization (NPI-2)
- Legal business name
- Emberlight Therapy LLC
- Organization subpart
- No
- Enumeration date
- Oct 30, 2025
- Certification date
- Oct 30, 2025
- Last updated
- Oct 30, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
2575 Heritage DrMendota Heights, MN 55120-1737
Phone 612-608-9068
Mailing address
2575 Heritage DrMendota Heights, MN 55120-1737
Phone 612-608-9068
Authorized official
Nicole Davis
Owner
6126089068
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