MEDICARE: BE EMPOWERED COUNSELING SERVICES 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1922715051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE EMPOWERED COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	283 HAMILTON ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01604-2228
Country	:	US
Telephone Number	:	617-433-7469
Fax Number	:

Provider Business Practice Location Address
First Line	:	283 HAMILTON ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01604-2228
Country	:	US
Telephone Number	:	617-433-7469
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/ OWNER
Name	:	ALICIA S GREY
Credential	:	LMHC
Telephone Number	:	617-433-7469

Provider Enumeration Date	:	10/28/2022
Last Update Date	:	10/28/2022

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