Provider Demographics
NPI:1912521303
Name:EMPOWERING TRANSFORMATIONS COUNSELING LLC
Entity Type:Organization
Organization Name:EMPOWERING TRANSFORMATIONS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANZANIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-881-6021
Mailing Address - Street 1:PO BOX 210132
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221-8003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5205 N IRONWOOD RD STE 117
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-4907
Practice Address - Country:US
Practice Address - Phone:414-220-0752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty