Provider Demographics
NPI:1164295671
Name:EMPOWERED FAMILY SOLUTIONS BEHAVIORAL HEALTH PLLC
Entity Type:Organization
Organization Name:EMPOWERED FAMILY SOLUTIONS BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CALISSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:YEPIZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:602-960-7795
Mailing Address - Street 1:20118 N 67TH AVE STE 426
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-4621
Mailing Address - Country:US
Mailing Address - Phone:602-960-7795
Mailing Address - Fax:602-584-5008
Practice Address - Street 1:13760 N 93RD AVE STE 111
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4250
Practice Address - Country:US
Practice Address - Phone:602-960-7795
Practice Address - Fax:602-584-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty