Provider Demographics
NPI:1356688642
Name:EMPOWERING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:EMPOWERING SOLUTIONS, LLC
Other - Org Name:MARITZA BOURASSA, LCSW
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOURASSA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-448-9755
Mailing Address - Street 1:481 GOLD STAR HWY STE 301
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-6702
Mailing Address - Country:US
Mailing Address - Phone:860-448-9755
Mailing Address - Fax:860-405-1910
Practice Address - Street 1:481 GOLD STAR HWY STE 301
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-6702
Practice Address - Country:US
Practice Address - Phone:860-448-9755
Practice Address - Fax:860-405-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0050191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT005019OtherST. OF CT. LCSW NUMBER
CT004259059Medicaid
CT004259059Medicaid