Healthcare Provider Details

I. General information

NPI: 1588573943
Provider Name (Legal Business Name): EMPOWER BY MARISSA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 VILLANOVA CT
BERLIN NJ
08009-2219
US

IV. Provider business mailing address

3 VILLANOVA CT
BERLIN NJ
08009-2219
US

V. Phone/Fax

Practice location:
  • Phone: 609-481-8095
  • Fax:
Mailing address:
  • Phone: 609-481-8095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARISSA STRADER
Title or Position: OWNER
Credential:
Phone: 609-481-8095