Provider Demographics
NPI:1922606847
Name:EMPOWERING LIVES COUNSELING LLC
Entity Type:Organization
Organization Name:EMPOWERING LIVES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAVREK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-530-7186
Mailing Address - Street 1:160 PINNACLE RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-2219
Mailing Address - Country:US
Mailing Address - Phone:720-530-7186
Mailing Address - Fax:
Practice Address - Street 1:49 BROAD ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-4201
Practice Address - Country:US
Practice Address - Phone:720-530-7186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)