Provider Demographics
NPI:1346611639
Name:EMPOWERED HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:EMPOWERED HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TYRRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-757-8910
Mailing Address - Street 1:810 KOKOMO RD
Mailing Address - Street 2:STE 245A
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5075
Mailing Address - Country:US
Mailing Address - Phone:808-757-8910
Mailing Address - Fax:
Practice Address - Street 1:810 KOKOMO RD
Practice Address - Street 2:STE 245A
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-5075
Practice Address - Country:US
Practice Address - Phone:808-757-8910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI448251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health