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General NPI Number Information
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NPI Number | 1578355749
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Entity Type | Organization
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Legal Business Name | EMPOWERYOUTH LLC
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 7895 BROADWAY STE A
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5529
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Country | US
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Telephone | 219-247-8938
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Fax | 219-293-8221
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Provider Business Mailing Address
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Address Line | PO BOX 10613
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City | MERRILLVILLE
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State | IN
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Zip | 46411-0613
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Country | US
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Telephone | 219-201-9446
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RAQUELL D YARBROUGH
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Credential | LSW
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Telephone | 219-201-9446
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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 | 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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