=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962801787
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMPOWERING FAMILIES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2014
-----------------------------------------------------
Last Update Date | 08/18/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 720 KIPLING ST SUITE 113
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80215-8003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-432-5262
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 720 KIPLING ST SUITE 113
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80215-8003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-432-5262
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/COUNSELOR
-----------------------------------------------------
Name | LANA NICOLE ISAACSON
-----------------------------------------------------
Credential | LCSW, CAC III
-----------------------------------------------------
Telephone | 720-432-5262
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 1434
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------