Provider Demographics
NPI:1851914329
Name:EMPOWERING MINDS THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:EMPOWERING MINDS THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SKARLET
Authorized Official - Middle Name:D
Authorized Official - Last Name:FORWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:415-259-1211
Mailing Address - Street 1:304 S JONES BLVD # 2329
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-2623
Mailing Address - Country:US
Mailing Address - Phone:702-234-3311
Mailing Address - Fax:
Practice Address - Street 1:10629 CALDERA CANYON CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8692
Practice Address - Country:US
Practice Address - Phone:415-259-1211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty