Healthcare Provider Details

I. General information

NPI: 1821814047
Provider Name (Legal Business Name): EMPOWERED PATH COUNSELING AND CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 EATON ST
HAMPTON VA
23669-4079
US

IV. Provider business mailing address

101 EATON ST
HAMPTON VA
23669-4079
US

V. Phone/Fax

Practice location:
  • Phone: 757-206-2998
  • 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
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TAMIKA BRICE
Title or Position: OWNER
Credential: LPC
Phone: 757-206-2998