Provider Demographics
NPI:1922551183
Name:WOMEN OF POWER NETWORK
Entity Type:Organization
Organization Name:WOMEN OF POWER NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEKEESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER-JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-887-7848
Mailing Address - Street 1:11384 FOXHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1491
Mailing Address - Country:US
Mailing Address - Phone:203-887-7848
Mailing Address - Fax:
Practice Address - Street 1:11384 FOXHAVEN DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-1491
Practice Address - Country:US
Practice Address - Phone:203-887-7848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0102561041C0700X, 251S00000X, 302R00000X
CT009453251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance Organization