Provider Demographics
NPI:1184178147
Name:EMPOWERMENTTREATMENT & COUNSELING CENTER FOR WELLNESS
Entity type:Organization
Organization Name:EMPOWERMENTTREATMENT & COUNSELING CENTER FOR WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTIANESE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC, CEDS
Authorized Official - Phone:480-326-9421
Mailing Address - Street 1:5940 W UNION HILLS DR
Mailing Address - Street 2:D-200
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1308
Mailing Address - Country:US
Mailing Address - Phone:480-326-9421
Mailing Address - Fax:
Practice Address - Street 1:5940 W UNION HILLS DR
Practice Address - Street 2:D-200
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1308
Practice Address - Country:US
Practice Address - Phone:480-326-9421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-12986261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)