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General NPI Number Information
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NPI Number | 1548075658
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Entity Type | Organization
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Legal Business Name | DIVINE EMPOWERMENT, LLC
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 911 S PARSONS AVE STE F
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City | BRANDON
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State | FL
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Zip | 33511-6042
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Country | US
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Telephone | 941-539-4817
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Fax |
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Provider Business Mailing Address
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Address Line | 11303 WINDSOR POINTE DR APT 202
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City | BRANDON
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State | FL
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Zip | 33511-2739
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Country | US
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Telephone | 941-539-4817
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Fax |
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Authorized Official
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Title or Position | CEO/LICENSED CLINICAL SOCIAL WORKER
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Name | CAROLYN REDMOND
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Credential | LCSW
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Telephone | 941-539-4817
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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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