Provider Demographics
NPI:1740387877
Name:EMPACT INC.
Entity type:Organization
Organization Name:EMPACT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENSEL
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:WARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:937-390-7773
Mailing Address - Street 1:2207 OLYMPIC ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2736
Mailing Address - Country:US
Mailing Address - Phone:937-390-7773
Mailing Address - Fax:390-390-8765
Practice Address - Street 1:2207 OLYMPIC ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2736
Practice Address - Country:US
Practice Address - Phone:937-390-7773
Practice Address - Fax:390-390-8765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4444103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty