Healthcare Provider Details
I. General information
NPI: 1578386009
Provider Name (Legal Business Name): EMPOWERED MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16 ARCADIAN WAY STE C2
PARAMUS NJ
07652-1291
US
IV. Provider business mailing address
429-4 STATE ROUTE 31 S
WASHINGTON NJ
07882-4182
US
V. Phone/Fax
- Phone: 908-456-6453
- Fax:
- Phone: 908-271-8368
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELIZABETH
GONZALEZ HIDALGO
Title or Position: REGISTERED AGENT
Credential:
Phone: 908-456-6453