Healthcare Provider Details

I. General information

NPI: 1811819790
Provider Name (Legal Business Name): MIND EMPOWERMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3987 CLEVELAND ST
GARY IN
46408-2476
US

IV. Provider business mailing address

3987 CLEVELAND ST
GARY IN
46408-2476
US

V. Phone/Fax

Practice location:
  • Phone: 219-381-9024
  • Fax:
Mailing address:
  • Phone: 219-381-9024
  • 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: SUSAN WOODS
Title or Position: CEO
Credential:
Phone: 219-381-9024