Healthcare Provider Details

I. General information

NPI: 1144185273
Provider Name (Legal Business Name): EMPOWERED INNER PEACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 E PARIS AVE SE
GRAND RAPIDS MI
49512-1926
US

IV. Provider business mailing address

748 ATWOOD ST NE UNIT 2
GRAND RAPIDS MI
49503-3528
US

V. Phone/Fax

Practice location:
  • Phone: 248-756-3338
  • Fax:
Mailing address:
  • Phone: 248-756-3338
  • 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: JUSTINA REED
Title or Position: OWNER/MANAGING MEMBER
Credential: LMSW
Phone: 248-756-3338