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General NPI Number Information
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NPI Number | 1831896935
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Entity Type | Organization
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Legal Business Name | EMPOWERMENT COUNSELING CENTER
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 19900 GOVERNORS DR STE 201
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1061
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Country | US
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Telephone | 815-570-9417
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Fax |
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Provider Business Mailing Address
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Address Line | 19900 GOVERNORS DR STE 201
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1061
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Country | US
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Telephone | 815-570-9417
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. AMBER GARDNER
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Credential | EDD
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Telephone | 708-805-1420
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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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