Provider Demographics
NPI:1548885189
Name:EMPOWERED COUNSELING, PLLC
Entity type:Organization
Organization Name:EMPOWERED COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST AND OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTAN
Authorized Official - Middle Name:BENNETT
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-631-9771
Mailing Address - Street 1:7530 103RD ST STE 7
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-6786
Mailing Address - Country:US
Mailing Address - Phone:904-337-9073
Mailing Address - Fax:904-337-4448
Practice Address - Street 1:7530 103RD ST STE 7
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-6786
Practice Address - Country:US
Practice Address - Phone:904-337-9073
Practice Address - Fax:904-337-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health