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General NPI Number Information
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NPI Number | 1740045707
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Entity Type | Organization
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Legal Business Name | THE EMPOWERED PLACE - COUNSELING ADVOCACY CONSULTING LLC
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 2961 YARMOUTH GREENWAY DR STE 2
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City | FITCHBURG
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State | WI
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Zip | 53711-5809
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Country | US
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Telephone | 608-620-5380
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Fax |
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Provider Business Mailing Address
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Address Line | 4529 ARMISTICE LN
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City | MADISON
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State | WI
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Zip | 53704-3209
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Country | US
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Telephone | 217-316-4901
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY-NICHOLE FRITTS
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Credential | MA, LPC
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Telephone | 217-316-4901
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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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Taxonomy #2
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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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