Provider Demographics
NPI:1891501532
Name:EMPOWER CBT COUNSELING LLC
Entity type:Organization
Organization Name:EMPOWER CBT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APN
Authorized Official - Prefix:
Authorized Official - First Name:RAYWATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOCOOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-558-9107
Mailing Address - Street 1:1308 DARTMOUTH TER
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5506
Mailing Address - Country:US
Mailing Address - Phone:973-558-9107
Mailing Address - Fax:973-547-7868
Practice Address - Street 1:743 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1816
Practice Address - Country:US
Practice Address - Phone:973-558-9107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty