Healthcare Provider Details

I. General information

NPI: 1023716115
Provider Name (Legal Business Name): WOMENANDCHILDRENEMPOWERMENTINC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 02/20/2023
Certification Date: 02/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 CRANE AVE S
TAUNTON MA
02780-7232
US

IV. Provider business mailing address

825 CRANE AVE S
TAUNTON MA
02780-7232
US

V. Phone/Fax

Practice location:
  • Phone: 347-495-7087
  • Fax:
Mailing address:
  • Phone: 347-495-7087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUNA MICHEL
Title or Position: THERAPIST
Credential: LMHC
Phone: 347-495-7087