| Empowered Path LLC | |
|
873 Kings Arms Dr Virginia Beach VA 23452-6426 | |
| (757) 560-8911 | |
| Not Available |
| Full Name | Empowered Path LLC |
|---|---|
| Speciality | Counselor |
| Location | 873 Kings Arms Dr, Virginia Beach, Virginia |
| Authorized Official Name and Position | Theodore S Harden (OWNER) |
| Authorized Official Contact | 7575608911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Empowered Path LLC 873 Kings Arms Dr Virginia Beach VA 23452-6426 Ph: (757) 560-8911 | Empowered Path LLC 873 Kings Arms Dr Virginia Beach VA 23452-6426 Ph: (757) 560-8911 |
| NPI Number | 1134927452 |
|---|---|
| Provider Enumeration Date | 03/04/2025 |
| Last Update Date | 03/04/2025 |
| Certification Date | 03/04/2025 |
| Medicare PECOS PAC ID | 1153808274 |
|---|---|
| Medicare Enrollment ID | O20260121000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134927452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Primary |
| Provider Name | Theodore Harden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821803750 PECOS PAC ID: 2062999188 Enrollment ID: I20260121000286 |
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