Organization Active NPI

Empowered Journeys LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
National Provider Identifier
1376396820
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EMPOWERED JOURNEYS LLC
Practice address
6723 Weaver Rd Ste 120
Rockford, IL 61114-8021
Phone
(815) 216-5974
NPI assigned
Apr 5, 2024
Last updated
Jul 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Kathleen Brewer, LCSWNPI 1568971760
Title
Mental Health Therapist
Phone
(815) 978-2238

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6723 Weaver Rd Ste 120
Rockford, IL 61114-8021

Mailing address

6723 Weaver Rd Ste 120
Rockford, IL 61114-8021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240625000820 IL Part B Supplier - Clinic/Group Practice 1850834375 Receives reassigned benefits from 3 practitioners
Practice locations: Loves Park, IL; Rockford, IL

National Provider Directory

National Provider Directory

Locations

6723 Weaver Rd
Ste 120
Rockford, IL 61114
Phone (815) 216-5974

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1376396820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6723 WEAVER RD STE 120",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6723 WEAVER RD STE 120",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148021",
            "telephone_number": "815-216-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED JOURNEYS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "815-978-2238",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.