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NPI Code Detail

MEDICARE: EMPOWERMENT SPECIALISTS, LLC

MEDICARE: EMPOWERMENT SPECIALISTS, 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1962123570
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMPOWERMENT SPECIALISTS, LLC
Provider Business Mailing Address
First Line : PO BOX 131
Second Line :
City : WAKE FOREST
State : NC
Zip : 27588-0131
Country : US
Telephone Number : 919-961-7458
Fax Number :
Provider Business Practice Location Address
First Line : 525 S WHITE ST STE 208
Second Line :
City : WAKE FOREST
State : NC
Zip : 27587-2920
Country : US
Telephone Number : 919-961-7458
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RODNEY HARRIS
Credential : PHD, LPCS, NCC, ACS
Telephone Number : 919-961-7458
Provider Enumeration Date : 09/12/2022
Last Update Date : 09/12/2022

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