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General NPI Number Information
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NPI Number | 1841745841
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Entity Type | Organization
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Legal Business Name | EMPOWERMENT BEHAVIORAL THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 08/18/2016
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 6475 NEW HAMPSHIRE AVE # C-700
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City | HYATTSVILLE
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State | MD
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Zip | 20783-3269
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Country | US
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Telephone | 240-565-2558
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Fax |
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Provider Business Mailing Address
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Address Line | 1217 ARCOLA AVE
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City | SILVER SPRING
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State | MD
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Zip | 20902-3407
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Country | US
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Telephone | 240-565-2558
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | DAVID SHRANK
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Credential | LCSW-C, LICSW
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Telephone | 240-565-2558
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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 | LC50080481
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19015
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License Number State | MD
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