Provider Demographics
NPI:1316485360
Name:EMPOWER COUNSELING LLC
Entity type:Organization
Organization Name:EMPOWER COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:BARRETO
Authorized Official - Last Name:LAGEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW/CSW
Authorized Official - Phone:801-897-6728
Mailing Address - Street 1:8823 S REDWOOD RD STE B
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-9281
Mailing Address - Country:US
Mailing Address - Phone:801-897-6728
Mailing Address - Fax:
Practice Address - Street 1:3856 N NEWLAND LOOP UNIT 5
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4917
Practice Address - Country:US
Practice Address - Phone:801-897-6728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT89309283502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT20170206615409Medicaid