MEDICARE: EMPOWERING COUNSEL

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1639800618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERING COUNSEL

Provider Business Mailing Address
First Line	:	8003 MAURICE RD APT C
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-1640
Country	:	US
Telephone Number	:	501-398-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	8205 HIGHWAY 161
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-1808
Country	:	US
Telephone Number	:	501-313-1125
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	KNIKIAH A. BANKS SR.
Credential	:	LPC
Telephone Number	:	501-313-1125

Provider Enumeration Date	:	06/21/2022
Last Update Date	:	06/21/2022

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Directions to “EMPOWERING COUNSEL ” Practice Location

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