Healthcare Provider Details

I. General information

NPI: 1386443893
Provider Name (Legal Business Name): THE EMPOWERMENT PRACTICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 BOYLSTON STREET 5TH FL. STE. 1930
BOSTON MA
02116-2774
US

IV. Provider business mailing address

867 BOYLSTON STREET 5TH FL. STE. 1930
BOSTON MA
02116-2774
US

V. Phone/Fax

Practice location:
  • Phone: 617-383-7309
  • Fax: 617-977-5595
Mailing address:
  • Phone: 617-383-7309
  • Fax: 617-977-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GINNELLE VASQUEZ
Title or Position: OWNER
Credential: LICSW
Phone: 617-383-7309