Healthcare Provider Details

I. General information

NPI: 1609766849
Provider Name (Legal Business Name): MPOWER COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 E MAIN ST
DANVILLE IL
61832-6037
US

IV. Provider business mailing address

1300 E MAIN ST
DANVILLE IL
61832-5051
US

V. Phone/Fax

Practice location:
  • Phone: 217-213-6114
  • Fax:
Mailing address:
  • Phone: 217-213-6114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICKENSY LEIGH ELLIS-WHITE
Title or Position: OWNER
Credential:
Phone: 217-213-6114