Healthcare Provider Details

I. General information

NPI: 1740802180
Provider Name (Legal Business Name): EMPOWER U COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5203 KK RD
WATERLOO IL
62298-3415
US

IV. Provider business mailing address

5203 KK RD
WATERLOO IL
62298-3415
US

V. Phone/Fax

Practice location:
  • Phone: 618-779-0274
  • Fax:
Mailing address:
  • Phone: 618-779-0274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE MARIE BRINKMANN
Title or Position: OWNER
Credential: LCSW
Phone: 618-779-0274