1710769690 NPI number — EMPOWERMENT COUNSELING GROUP, INC

Table of content: (NPI 1710769690)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710769690 NPI number — EMPOWERMENT COUNSELING GROUP, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMPOWERMENT COUNSELING GROUP, INC
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:
1710769690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
224 MAPLE TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVIE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33325-6752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-479-2767
Provider Business Mailing Address Fax Number:
954-231-4390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 S PINE ISLAND RD STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33324-2620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-479-2767
Provider Business Practice Location Address Fax Number:
954-231-4390
Provider Enumeration Date:
10/16/2023

Additional Information

Authorized Official

Authorized Official Last Name:
LEVASSEUR
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
954-479-2767

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com