Provider Demographics
NPI:1457157281
Name:MPOWERED WELLNESS
Entity type:Organization
Organization Name:MPOWERED WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-550-1812
Mailing Address - Street 1:2692 W OXFORD LOOP STE 102
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5569
Mailing Address - Country:US
Mailing Address - Phone:662-732-2536
Mailing Address - Fax:662-238-4122
Practice Address - Street 1:2692 W OXFORD LOOP STE 102
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5569
Practice Address - Country:US
Practice Address - Phone:662-732-2536
Practice Address - Fax:662-238-4122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty