Provider Demographics
NPI:1841769890
Name:EMPOWERED TO THRIVE COUNSELING AND WELLNESS, LLC
Entity Type:Organization
Organization Name:EMPOWERED TO THRIVE COUNSELING AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-516-4891
Mailing Address - Street 1:221 RUTHERS RD STE 102
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5395
Mailing Address - Country:US
Mailing Address - Phone:804-396-4678
Mailing Address - Fax:
Practice Address - Street 1:221 RUTHERS RD STE 102
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5395
Practice Address - Country:US
Practice Address - Phone:804-396-4678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-20
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty