Provider Demographics
NPI:1093479677
Name:EMPOWERING MINDZ, LLC
Entity Type:Organization
Organization Name:EMPOWERING MINDZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:VASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, MAC, CSC-AD
Authorized Official - Phone:443-453-1161
Mailing Address - Street 1:583 FREDERICK RD STE 6C
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4697
Mailing Address - Country:US
Mailing Address - Phone:443-453-1161
Mailing Address - Fax:
Practice Address - Street 1:583 FREDERICK RD STE 6C
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4697
Practice Address - Country:US
Practice Address - Phone:443-453-1161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder