Healthcare Provider Details

I. General information

NPI: 1780597369
Provider Name (Legal Business Name): EMPOWERING MIND AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE 22335
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE 22335
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 215-280-8027
  • Fax:
Mailing address:
  • Phone: 215-380-8027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. NICOLE LEE
Title or Position: OWNER
Credential: APRN,FNP-C,PMHNP-BC
Phone: 215-380-8027