Provider Demographics
NPI:1871542803
Name:EMPOWERMENT COUNSELING SERVICES
Entity type:Organization
Organization Name:EMPOWERMENT COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LILLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANDIKUSIC
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:801-695-1316
Mailing Address - Street 1:P.O. BOX 12842
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84412
Mailing Address - Country:US
Mailing Address - Phone:801-695-1316
Mailing Address - Fax:801-649-0964
Practice Address - Street 1:466 N. MAIN ST
Practice Address - Street 2:STE 201E
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015
Practice Address - Country:US
Practice Address - Phone:801-695-1316
Practice Address - Fax:801-649-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty