Healthcare Provider Details

I. General information

NPI: 1558178855
Provider Name (Legal Business Name): EMPOWERMENT SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E 39TH ST STE 5C
KANSAS CITY MO
64111-1531
US

IV. Provider business mailing address

200 WESTPORT RD UNIT 5807
KANSAS CITY MO
64171-1202
US

V. Phone/Fax

Practice location:
  • Phone: 816-934-1344
  • Fax:
Mailing address:
  • Phone: 816-695-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL D DEPRIEST SR.
Title or Position: OWNER
Credential: CRADC, CPS
Phone: 816-695-1555