Healthcare Provider Details

I. General information

NPI: 1508429291
Provider Name (Legal Business Name): EMPOWER YOU THERAPY & COACHING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4570 CHURCHILL ST STE 220
SHOREVIEW MN
55126-2274
US

IV. Provider business mailing address

4570 CHURCHILL ST STE 220
SHOREVIEW MN
55126-2274
US

V. Phone/Fax

Practice location:
  • Phone: 612-808-0953
  • Fax: 612-421-0020
Mailing address:
  • Phone: 612-808-0953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNA D SCANLAN
Title or Position: CEO/THERAPIST
Credential: MA, LMFT
Phone: 612-808-0953