Provider Demographics
NPI:1679369755
Name:EMPOWERING MINDS
Entity type:Organization
Organization Name:EMPOWERING MINDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RBT
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:DYLAN
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-896-5946
Mailing Address - Street 1:124 THOMAS DR SE
Mailing Address - Street 2:
Mailing Address - City:LAUREL HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32567-3617
Mailing Address - Country:US
Mailing Address - Phone:850-896-5946
Mailing Address - Fax:
Practice Address - Street 1:1001 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-6943
Practice Address - Country:US
Practice Address - Phone:850-400-6098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty