Healthcare Provider Details

I. General information

NPI: 1457004285
Provider Name (Legal Business Name): EMPOWERING ZONE COUNSELING & CONSULTING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/01/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E WASHINGTON AVE STE 252
JACKSON MI
49201-2393
US

IV. Provider business mailing address

PO BOX 625
JACKSON MI
49204-0625
US

V. Phone/Fax

Practice location:
  • Phone: 517-435-2176
  • Fax:
Mailing address:
  • Phone: 517-435-2176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. J. FREDERICK BLAND
Title or Position: OWNER/THERAPIST
Credential: PH.D., NCC, LPC, CAC
Phone: 517-435-2176