Provider Demographics
NPI: | 1386669042 |
---|---|
Name: | EMPOWER COUNSELING SERVICES, INC |
Entity type: | Organization |
Organization Name: | EMPOWER COUNSELING SERVICES, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF FINANCIAL OFFICER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | LILA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KHALILI |
Authorized Official - Suffix: | X |
Authorized Official - Credentials: | LCSW |
Authorized Official - Phone: | 714-624-0651 |
Mailing Address - Street 1: | 3055 W ORANGE AVE STE 206 |
Mailing Address - Street 2: | |
Mailing Address - City: | ANAHEIM |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92804-3154 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 714-624-0651 |
Mailing Address - Fax: | 714-998-2941 |
Practice Address - Street 1: | 3055 W ORANGE AVE STE 206 |
Practice Address - Street 2: | |
Practice Address - City: | ANAHEIM |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92804-3154 |
Practice Address - Country: | US |
Practice Address - Phone: | 714-624-0651 |
Practice Address - Fax: | 714-998-2941 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-13 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | LCS21648 | 251B00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251B00000X | Agencies | Case Management |