Provider Demographics
NPI:1952124893
Name:EMPOWER COUNSELING PLLC (LIMITED CO.)
Entity type:Organization
Organization Name:EMPOWER COUNSELING PLLC (LIMITED CO.)
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:THORNDYKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-268-8454
Mailing Address - Street 1:2601 TRAVERSE TRL
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-0990
Mailing Address - Country:US
Mailing Address - Phone:208-268-8454
Mailing Address - Fax:877-349-8855
Practice Address - Street 1:1223 AUGUSTA WEST PKWY STE I
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1807
Practice Address - Country:US
Practice Address - Phone:208-268-8454
Practice Address - Fax:877-349-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty