Provider Demographics
NPI:1235005471
Name:EMPOWERED MARIPOSA LLC
Entity type:Organization
Organization Name:EMPOWERED MARIPOSA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ GUALAJARA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:480-818-9276
Mailing Address - Street 1:4100 S LINDSAY RD STE 124
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-1508
Mailing Address - Country:US
Mailing Address - Phone:480-818-9276
Mailing Address - Fax:
Practice Address - Street 1:4100 S LINDSAY RD STE 124
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-1508
Practice Address - Country:US
Practice Address - Phone:480-818-9276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty