Healthcare Provider Details

I. General information

NPI: 1740931146
Provider Name (Legal Business Name): EMPOWERING ME EMPOWERING THE MENTAL EMPOWERING THE EMOTIONAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 NE LOOP 410 STE 116
SAN ANTONIO TX
78216-5844
US

IV. Provider business mailing address

702 RICHLAND HILLS DR UNIT 769118
SAN ANTONIO TX
78245-4400
US

V. Phone/Fax

Practice location:
  • Phone: 210-274-4919
  • Fax: 210-239-5509
Mailing address:
  • Phone: 210-274-4919
  • Fax: 210-239-5509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: NATHASHA S BANKS
Title or Position: OWNER OPERATOR
Credential:
Phone: 210-274-4919