Healthcare Provider Details

I. General information

NPI: 1043996341
Provider Name (Legal Business Name): EMPOWER PLUS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6802 PARAGON PL STE 410
RICHMOND VA
23230-1655
US

IV. Provider business mailing address

6802 PARAGON PL STE 410
RICHMOND VA
23230-1655
US

V. Phone/Fax

Practice location:
  • Phone: 844-222-1173
  • Fax: 718-387-6429
Mailing address:
  • Phone: 844-222-1173
  • Fax: 718-387-6429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PEARL GOLDWURM
Title or Position: CEO
Credential: LBA
Phone: 844-222-1173