Healthcare Provider Details

I. General information

NPI: 1528921178
Provider Name (Legal Business Name): EMPOWERING SOULS THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 N 3RD ST
SAINT JOSEPH IL
61873-9566
US

IV. Provider business mailing address

510 N 3RD ST
SAINT JOSEPH IL
61873-9566
US

V. Phone/Fax

Practice location:
  • Phone: 217-898-7101
  • Fax:
Mailing address:
  • Phone: 217-898-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRANDIE CIOTA
Title or Position: OWNER, LCSW
Credential: LCSW
Phone: 217-898-7101