| Empower Therapeutic Services LLC | |
|
3100 Drewsky Ln Unit 108 Fort Mill SC 29715-0112 | |
| (404) 840-6462 | |
| Not Available |
| Full Name | Empower Therapeutic Services LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 3100 Drewsky Ln Unit 108, Fort Mill, South Carolina |
| Authorized Official Name and Position | Latonia K Johnson (OWNER) |
| Authorized Official Contact | 4048406462 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Empower Therapeutic Services LLC 3100 Drewsky Ln Unit 108 Fort Mill SC 29715-0112 Ph: (404) 840-6462 | Empower Therapeutic Services LLC 3100 Drewsky Ln Unit 108 Fort Mill SC 29715-0112 Ph: (404) 840-6462 |
| NPI Number | 1073377610 |
|---|---|
| Provider Enumeration Date | 02/13/2024 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Medicare PECOS PAC ID | 9537600796 |
|---|---|
| Medicare Enrollment ID | O20240916002752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073377610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
| Provider Name | Latonia Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275772402 PECOS PAC ID: 6507182144 Enrollment ID: I20240916002940 |
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