Healthcare Provider Details

I. General information

NPI: 1447179270
Provider Name (Legal Business Name): EMPOWERED STATE MENTAL HEALTH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 BROADWAY # 6262
ALBANY NY
12207-2922
US

IV. Provider business mailing address

418 BROADWAY # 6262
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 347-448-0011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA JUN
Title or Position: OWNER/MANAGING MEMBER
Credential: LMHC
Phone: 347-448-0011