Empowered Sol Wellness Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EMPOWERED SOL WELLNESS CENTER, LLC

Practice address

7530 103Rd St Ste 7
Jacksonville, FL 32210-6786

Phone

(904) 872-2225

Fax

(406) 559-3241

NPI assigned

Jun 24, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terri Huston

Title

Owner

Phone

(406) 781-2314

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Lynn Huston, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1992947519
  Medicare reassignment NPD
• Christan Latonya Bennett, MSW, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1114266731
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1124689880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7530 103RD ST STE 7",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106786",
            "telephone_number": "904-872-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 103RD ST STE 7",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106786",
            "telephone_number": "904-872-2225",
            "fax_number": "406-559-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED SOL WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-24",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "HUSTON",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-781-2314"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "terri@empoweredsolwellness.com",
            "affiliation": "N",
            "endpointDescription": "HIPAA compliant email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7530 103rd St Ste 7",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322106786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Amanda Caroline Emrick, BCBA

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.