Healthcare Provider Details

I. General information

NPI: 1912852732
Provider Name (Legal Business Name): EMPOWER IMPACT SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 BRENTWOOD DR N STE B
WILSON NC
27896-1784
US

IV. Provider business mailing address

5540 CENTERVIEW DR STE 200
RALEIGH NC
27606-3386
US

V. Phone/Fax

Practice location:
  • Phone: 919-568-1710
  • Fax: 919-568-1712
Mailing address:
  • Phone: 919-568-1710
  • Fax: 919-568-1712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY WILLIAMS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 919-717-0585