Healthcare Provider Details

I. General information

NPI: 1356036263
Provider Name (Legal Business Name): EMPOWERMENT COUNSELING & TRAINING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11325 PEMBROOKE SQ STE 114
WALDORF MD
20603-4807
US

IV. Provider business mailing address

13106 HAMPTON FARM LN
BRANDYWINE MD
20613-5812
US

V. Phone/Fax

Practice location:
  • Phone: 202-441-7989
  • Fax:
Mailing address:
  • Phone: 202-441-7989
  • 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: DR. ROBERT LEWIS EVANS III
Title or Position: OWNER
Credential: LCPC
Phone: 202-441-7989