Healthcare Provider Details

I. General information

NPI: 1114868288
Provider Name (Legal Business Name): EMPOWERED PATH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 N RIVERSIDE DR
GURNEE IL
60031-5908
US

IV. Provider business mailing address

1093 ELLSWORTH DR
GRAYSLAKE IL
60030-3364
US

V. Phone/Fax

Practice location:
  • Phone: 847-445-8606
  • Fax:
Mailing address:
  • Phone: 847-445-8606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DIANN KAY POMEROY
Title or Position: OWNER
Credential: LCPC
Phone: 847-445-8606