Provider Demographics
NPI:1396363487
Name:EMPOWERMENT COUNSELING SERVICES
Entity Type:Organization
Organization Name:EMPOWERMENT COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:734-335-4594
Mailing Address - Street 1:23772 WEST RD # 113
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48183-3050
Mailing Address - Country:US
Mailing Address - Phone:734-626-7648
Mailing Address - Fax:
Practice Address - Street 1:23772 WEST RD # 113
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-3050
Practice Address - Country:US
Practice Address - Phone:734-626-7648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========Medicaid