Healthcare Provider Details

I. General information

NPI: 1871162339
Provider Name (Legal Business Name): EMPOWERED CITIZENS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2021
Last Update Date: 06/20/2021
Certification Date: 06/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 N ARENDELL AVE
ZEBULON NC
27597-2305
US

IV. Provider business mailing address

815 N ARENDELL AVE
ZEBULON NC
27597-2305
US

V. Phone/Fax

Practice location:
  • Phone: 919-638-4451
  • Fax:
Mailing address:
  • Phone: 919-638-4451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: WENDI MARIA WATSON
Title or Position: FOUNDER/EXECUTIVE DIRECTOR
Credential: LCAS, LCSWA
Phone: 919-638-4451