Healthcare Provider Details

I. General information

NPI: 1841162062
Provider Name (Legal Business Name): A EMPOWERMENT CIRCLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8929 J M KEYNES DR # 330E
CHARLOTTE NC
28262-8406
US

IV. Provider business mailing address

8929 J M KEYNES DR # 330E
CHARLOTTE NC
28262-8406
US

V. Phone/Fax

Practice location:
  • Phone: 704-900-7488
  • Fax:
Mailing address:
  • Phone: 704-900-7488
  • Fax: 855-583-7047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEMETREE BENTON
Title or Position: CO-OWNER
Credential:
Phone: 704-208-0138