Provider Demographics
NPI:1083322069
Name:DREAM EMPOWERED, LLC
Entity Type:Organization
Organization Name:DREAM EMPOWERED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAZZMYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:302-867-7377
Mailing Address - Street 1:2014 STONEBRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-6730
Mailing Address - Country:US
Mailing Address - Phone:302-867-7377
Mailing Address - Fax:
Practice Address - Street 1:101 W PARK PL
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1324
Practice Address - Country:US
Practice Address - Phone:302-867-7377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)