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General NPI Number Information
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NPI Number | 1568247286
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Entity Type | Organization
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Legal Business Name | EMPOWERING GROWTH LLC
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 64 MAIN ST
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City | OSWEGO
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State | IL
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Zip | 60543-9893
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Country | US
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Telephone | 815-488-9727
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Fax |
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Provider Business Mailing Address
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Address Line | 149 S EDGELAWN DR
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City | AURORA
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State | IL
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Zip | 60506-4509
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Country | US
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Telephone | 815-488-9727
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | ABBY CAMPBELL
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Credential | LCSW, MSW
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Telephone | 815-488-9727
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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 | 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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