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General NPI Number Information
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NPI Number | 1710742143
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Entity Type | Organization
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Legal Business Name | EMPOWERED MINDS THERAPY LCSW PLLC
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 412 6TH AVE STE 501
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City | NEW YORK
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State | NY
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Zip | 10011-8409
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Country | US
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Telephone | 917-382-1149
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Fax |
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Provider Business Mailing Address
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Address Line | 4 PETER COOPER RD APT MH
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City | NEW YORK
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State | NY
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Zip | 10010-6736
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Country | US
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Telephone | 585-409-8361
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER MARIE ARMIJO
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Credential | LCSW
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Telephone | 585-409-8361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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