Provider Demographics
NPI:1053094862
Name:EMPOWERING INITIATIVE LICENSED CLINICAL SOCIAL WORKER LCSW INC
Entity type:Organization
Organization Name:EMPOWERING INITIATIVE LICENSED CLINICAL SOCIAL WORKER LCSW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WES
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HARDCASTLE-ORR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-695-7863
Mailing Address - Street 1:1401 21ST ST STE R
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-5226
Mailing Address - Country:US
Mailing Address - Phone:855-650-7585
Mailing Address - Fax:912-454-4232
Practice Address - Street 1:2560 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-9576
Practice Address - Country:US
Practice Address - Phone:855-650-7585
Practice Address - Fax:912-454-4232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPOWERING INITIATIVE LICENSED CLINICAL SOCIAL WORKER LCSW INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty