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General NPI Number Information
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NPI Number | 1548026123
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Entity Type | Organization
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Legal Business Name | EMPOWERED GROWTH COUNSELING PLLC
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 1303 W MAXWELL AVE
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City | SPOKANE
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State | WA
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Zip | 99201-2714
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Country | US
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Telephone | 509-991-9962
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Fax |
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Provider Business Mailing Address
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Address Line | 901 E 2ND AVE STE 208
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City | SPOKANE
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State | WA
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Zip | 99202-2257
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | CARISSA N PEDEN
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Credential | LMHC
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Telephone | 509-991-2029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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