| Empowered Thought Therapy Llc | |
|
2348 Corona Ave Medford OR 97504-4729 | |
| (541) 414-7980 | |
| Not Available |
| Full Name | Empowered Thought Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2348 Corona Ave, Medford, Oregon |
| Authorized Official Name and Position | Elizabeth Allred (OWNER) |
| Authorized Official Contact | 5414147980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Empowered Thought Therapy Llc Po Box 1787 Medford OR 97501-0261 Ph: (541) 500-8655 | Empowered Thought Therapy Llc 2348 Corona Ave Medford OR 97504-4729 Ph: (541) 414-7980 |
| NPI Number | 1124880414 |
|---|---|
| Provider Enumeration Date | 01/23/2024 |
| Last Update Date | 01/23/2024 |
| Certification Date | 01/23/2024 |
| Medicare PECOS PAC ID | 0941646459 |
|---|---|
| Medicare Enrollment ID | O20240306004148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124880414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Allred |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417466103 PECOS PAC ID: 1850737362 Enrollment ID: I20240306004161 |
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