Provider Demographics
NPI:1255012159
Name:EMPOWER AND THRIVE BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:EMPOWER AND THRIVE BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:971-917-7881
Mailing Address - Street 1:PO BOX 451
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-0451
Mailing Address - Country:US
Mailing Address - Phone:971-917-7881
Mailing Address - Fax:503-506-0499
Practice Address - Street 1:181 N GRANT ST STE 204
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3600
Practice Address - Country:US
Practice Address - Phone:971-917-7881
Practice Address - Fax:503-506-0499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty