Provider Demographics
NPI:1518263433
Name:EMPOWERED TO CHANGE, LLC
Entity Type:Organization
Organization Name:EMPOWERED TO CHANGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:ARENA
Authorized Official - Last Name:ALARIE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-826-0670
Mailing Address - Street 1:339 WASHINGTON ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1870
Mailing Address - Country:US
Mailing Address - Phone:617-826-0670
Mailing Address - Fax:
Practice Address - Street 1:339 WASHINGTON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1870
Practice Address - Country:US
Practice Address - Phone:617-826-0670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9272103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty