Provider Demographics
NPI:1053296905
Name:EMPOWER YOU FOUNDATION INC
Entity type:Organization
Organization Name:EMPOWER YOU FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:317-493-6456
Mailing Address - Street 1:5140 E SOUTHPORT RD STE 1041
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9601
Mailing Address - Country:US
Mailing Address - Phone:463-800-3384
Mailing Address - Fax:463-388-2323
Practice Address - Street 1:600 E CARMEL DR STE 117
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3049
Practice Address - Country:US
Practice Address - Phone:463-999-9203
Practice Address - Fax:463-388-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-09
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder