MEDICARE: EMPOWERED GROWTH, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1356189260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERED GROWTH, PLLC

Provider Business Mailing Address
First Line	:	8710 CHOCTAW RD STE 2A
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-3472
Country	:	US
Telephone Number	:	804-214-6074
Fax Number	:

Provider Business Practice Location Address
First Line	:	8710 CHOCTAW RD STE 2A
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-3472
Country	:	US
Telephone Number	:	804-214-6074
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	KATHERINE VEASEY
Credential	:	LCSW
Telephone Number	:	804-214-6074

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	12/01/2025

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