MEDICARE: EMPOWERING WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1154144244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERING WELLNESS LLC

Provider Business Mailing Address
First Line	:	5450 FAR HILLS AVE STE 205
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-2346
Country	:	US
Telephone Number	:	937-230-4661
Fax Number	:

Provider Business Practice Location Address
First Line	:	5450 FAR HILLS AVE STE 205
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-2346
Country	:	US
Telephone Number	:	937-230-4661
Fax Number	:

Authorized Official
Title or Position	:	COUNSELING
Name	:	RYAN TAYLOR
Credential	:	LPCC-S
Telephone Number	:	937-230-4661

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	11/06/2024

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Directions to “EMPOWERING WELLNESS LLC ” Practice Location

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