Provider Demographics
NPI:1447956511
Name:EMPOWERED LIFE COUNSELING LLC
Entity type:Organization
Organization Name:EMPOWERED LIFE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIEG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:317-476-5905
Mailing Address - Street 1:5319 W 200 S
Mailing Address - Street 2:
Mailing Address - City:NEW PALESTINE
Mailing Address - State:IN
Mailing Address - Zip Code:46163-8810
Mailing Address - Country:US
Mailing Address - Phone:317-476-5905
Mailing Address - Fax:
Practice Address - Street 1:9465 COUNSELORS ROW
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-6423
Practice Address - Country:US
Practice Address - Phone:317-476-5905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty