Provider Demographics
NPI:1528763067
Name:EMPOWER TODAY THERAPY LLC
Entity type:Organization
Organization Name:EMPOWER TODAY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:BERLYN
Authorized Official - Last Name:GUISE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:972-837-0065
Mailing Address - Street 1:1992 LEWIS TURNER BLVD STE 1132
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1255
Mailing Address - Country:US
Mailing Address - Phone:850-332-4127
Mailing Address - Fax:
Practice Address - Street 1:1992 LEWIS TURNER BLVD STE 1132
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1255
Practice Address - Country:US
Practice Address - Phone:850-332-4127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health