Provider Demographics
NPI:1013355460
Name:EMPOWERMENT BEHAVIORAL SERVICES,LLC
Entity Type:Organization
Organization Name:EMPOWERMENT BEHAVIORAL SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WHITLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:812-454-8829
Mailing Address - Street 1:815 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-2746
Mailing Address - Country:US
Mailing Address - Phone:812-454-8829
Mailing Address - Fax:
Practice Address - Street 1:815 JOHN ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-2746
Practice Address - Country:US
Practice Address - Phone:812-454-8829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006278A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health