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NPI 1457004285

NPI 1457004285 : EMPOWERING ZONE COUNSELING & CONSULTING SERVICES, PLLC : JACKSON, MI

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General NPI Number Information
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    NPI Number           |    1457004285
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    Entity Type          |    Organization 
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    Legal Business Name  |    EMPOWERING ZONE COUNSELING & CONSULTING SERVICES, PLLC 
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Dates
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    Enumeration Date     |    02/01/2022
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    Last Update Date     |    02/01/2022
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Provider Practice Location Address
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    Address Line         |    209 E WASHINGTON AVE STE 252 
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    City                 |    JACKSON
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    State                |    MI
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    Zip                  |    49201-2393
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    Country              |    US
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    Telephone            |    517-435-2176
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 625 
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    City                 |    JACKSON
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    State                |    MI
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    Zip                  |    49204-0625
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    Country              |    US
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    Telephone            |    517-435-2176
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/THERAPIST
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    Name                 |    DR. J. FREDERICK  BLAND 
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    Credential           |    PH.D., NCC, LPC, CAC
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    Telephone            |    517-435-2176
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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        |    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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