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General NPI Number Information
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NPI Number | 1053296905
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Entity Type | Organization
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Legal Business Name | EMPOWER YOU FOUNDATION INC
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Dates
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Enumeration Date | 08/09/2025
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Last Update Date | 08/09/2025
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Provider Practice Location Address
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Address Line | 600 E CARMEL DR STE 117
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City | CARMEL
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State | IN
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Zip | 46032-3049
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Country | US
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Telephone | 463-999-9203
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Fax | 463-388-2323
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Provider Business Mailing Address
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Address Line | 5140 E SOUTHPORT RD STE 1041
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City | SOUTHPORT
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State | IN
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Zip | 46237-9601
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Country | US
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Telephone | 463-800-3384
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Fax | 463-388-2323
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Authorized Official
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Title or Position | PMHNP/PRESIDENT
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Name | CANDICE JACKSON
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Credential | NP
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Telephone | 317-493-6456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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