1386443893 NPI number — THE EMPOWERMENT PRACTICE, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386443893 NPI number — THE EMPOWERMENT PRACTICE, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE EMPOWERMENT PRACTICE, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386443893
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
867 BOYLSTON STREET
Provider Second Line Business Mailing Address:
5TH FL. STE. 1930
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02116-2774
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-383-7309
Provider Business Mailing Address Fax Number:
617-977-5595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
867 BOYLSTON STREET
Provider Second Line Business Practice Location Address:
5TH FL. STE. 1930
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02116-2774
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-383-7309
Provider Business Practice Location Address Fax Number:
617-977-5595
Provider Enumeration Date:
03/10/2025

Additional Information

Authorized Official

Authorized Official Last Name:
VASQUEZ
Authorized Official First Name:
GINNELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
617-383-7309

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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