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NPI Code Detail

MEDICARE: EMPOWER MENTAL PERFORMANCE CONSULTING, LLC

MEDICARE: EMPOWER MENTAL PERFORMANCE CONSULTING, 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
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10OTHERN/A

General Provider Information

NPI Number : 1447974290
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPOWER MENTAL PERFORMANCE CONSULTING, LLC
Provider Business Mailing Address
First Line : 438 MOORFIELD AVE
Second Line :
City : NORTH AURORA
State : IL
Zip : 60542-4609
Country : US
Telephone Number : 815-201-2699
Fax Number :
Provider Business Practice Location Address
First Line : 438 MOORFIELD AVE
Second Line :
City : NORTH AURORA
State : IL
Zip : 60542-4609
Country : US
Telephone Number : 815-201-2699
Fax Number :
Authorized Official
Title or Position : CEO
Name : KEVIN BARTON
Credential : LPC, NCC, CMPC
Telephone Number : 815-201-2699
Provider Enumeration Date : 09/26/2022
Last Update Date : 09/26/2022

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Directions to “EMPOWER MENTAL PERFORMANCE CONSULTING, LLC ” Practice Location

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