=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003588120
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMPOWERING SOLUTIONZ LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2021
-----------------------------------------------------
Last Update Date | 03/10/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 102 E HICKS ST STE 105
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23868-1830
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-313-9689
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 137 CARTER RD
-----------------------------------------------------
City | EMPORIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23847-7861
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-637-7641
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | DAWN MARIE WALTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 434-313-9689
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------