Provider Demographics
NPI:1831686567
Name:BE EMPOWERED COACHING, INC.
Entity type:Organization
Organization Name:BE EMPOWERED COACHING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELANA
Authorized Official - Middle Name:MIRA
Authorized Official - Last Name:POLSYN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-610-8072
Mailing Address - Street 1:9319 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5635
Mailing Address - Country:US
Mailing Address - Phone:954-610-8072
Mailing Address - Fax:954-602-0836
Practice Address - Street 1:9319 WEST SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322
Practice Address - Country:US
Practice Address - Phone:954-610-8072
Practice Address - Fax:954-602-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW117101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty