MEDICARE: EMPOWERING WELLNESS HUB

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558194381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERING WELLNESS HUB

Provider Business Mailing Address
First Line	:	2244 IVY DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78418-3600
Country	:	US
Telephone Number	:	214-601-6167
Fax Number	:

Provider Business Practice Location Address
First Line	:	2244 IVY DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78418-3600
Country	:	US
Telephone Number	:	214-601-6167
Fax Number	:

Authorized Official
Title or Position	:	OWNER, LPC
Name	:	AUTUMN MORAN
Credential	:	LPC
Telephone Number	:	214-601-6167

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

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Directions to “EMPOWERING WELLNESS HUB ” Practice Location

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