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General NPI Number Information
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NPI Number | 1366019275
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Entity Type | Organization
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Legal Business Name | EMPOWERED VOICES LLC
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 41 WATCHUNG AVE STE 314
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City | MONTCLAIR
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State | NJ
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Zip | 07043-1337
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Country | US
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Telephone | 301-200-1884
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Fax |
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Provider Business Mailing Address
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Address Line | 41 WATCHUNG AVE STE 314
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City | MONTCLAIR
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State | NJ
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Zip | 07043-1337
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Country | US
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Telephone | 301-200-1884
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELLY GENTRY
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Credential | MA, LPC
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Telephone | 631-617-1487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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