Provider Demographics
NPI:1134589831
Name:THE EMPOWERMENT AGENCY LLC
Entity type:Organization
Organization Name:THE EMPOWERMENT AGENCY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:REINETTE
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-318-1897
Mailing Address - Street 1:PO BOX 42064
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-9002
Mailing Address - Country:US
Mailing Address - Phone:770-318-1897
Mailing Address - Fax:
Practice Address - Street 1:450 BROWNLEE RD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-2226
Practice Address - Country:US
Practice Address - Phone:770-318-1897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 1041C0700X, 251B00000X, 251K00000X, 261QM0850X
GACSW005414251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health