Healthcare Provider Details

I. General information

NPI: 1649980376
Provider Name (Legal Business Name): EMPOWER THERAPY ATX, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 12/05/2022
Certification Date: 12/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 N LAMAR BLVD SUITE 305
AUSTIN TX
78705
US

IV. Provider business mailing address

505 E 54TH ST UNIT B
AUSTIN TX
78751-1304
US

V. Phone/Fax

Practice location:
  • Phone: 512-253-1353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAUREN DAVID
Title or Position: OWNER, LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 512-507-3231