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General NPI Number Information
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NPI Number | 1851881965
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Entity Type | Organization
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Legal Business Name | EMPOWERMENT COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 427 DIXWELL AVE
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 860-235-2388
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 418
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City | WATERFORD
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State | CT
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Zip | 06385-0418
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Country | US
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Telephone | 860-235-2388
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL C MARSHALL
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Credential | LMSW
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Telephone | 860-235-2388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 3903
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2789
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 196
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License Number State | CT
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