Healthcare Provider Details

I. General information

NPI: 1407581770
Provider Name (Legal Business Name): EMPOWERMENT THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N BREIEL BLVD
MIDDLETOWN OH
45042-3804
US

IV. Provider business mailing address

618 QUAIL RUN RD
MIDDLETOWN OH
45042-3836
US

V. Phone/Fax

Practice location:
  • Phone: 513-278-8448
  • Fax:
Mailing address:
  • Phone: 513-575-6645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH A WAGER
Title or Position: OWNER
Credential: LPCC
Phone: 513-575-6645