Provider Demographics
NPI:1275184731
Name:LIVE EMPOWERED THERAPY
Entity Type:Organization
Organization Name:LIVE EMPOWERED THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LAUREL
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:774-322-2175
Mailing Address - Street 1:31 CONNIE DR
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1645
Mailing Address - Country:US
Mailing Address - Phone:407-304-6030
Mailing Address - Fax:
Practice Address - Street 1:25 MESSENGER ST STE 7
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-5012
Practice Address - Country:US
Practice Address - Phone:774-322-2175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty