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General NPI Number Information
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NPI Number | 1952124893
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Entity Type | Organization
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Legal Business Name | EMPOWER COUNSELING PLLC (LIMITED CO.)
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1223 AUGUSTA WEST PKWY STE I
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City | AUGUSTA
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State | GA
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Zip | 30909-1807
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Country | US
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Telephone | 208-268-8454
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Fax | 877-349-8855
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Provider Business Mailing Address
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Address Line | 2601 TRAVERSE TRL
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City | EVANS
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State | GA
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Zip | 30809-0990
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Country | US
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Telephone | 208-268-8454
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Fax | 877-349-8855
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JEREMY M THORNDYKE
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Credential |
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Telephone | 208-268-8454
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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 |
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License Number State |
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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 |
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License Number State |
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