Provider Demographics
NPI:1376131938
Name:EMPOWERED BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:EMPOWERED BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:POWER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-226-1196
Mailing Address - Street 1:76 BEDFORD ST STE 12
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4640
Mailing Address - Country:US
Mailing Address - Phone:781-226-1196
Mailing Address - Fax:
Practice Address - Street 1:76 BEDFORD ST STE 12
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4640
Practice Address - Country:US
Practice Address - Phone:781-226-1196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty