Empowered2Change LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003415 Issued in GA

Legal business name

EMPOWERED2CHANGE LLC

Practice address

5604 Wendy Bagwell Pkwy
Suite 812
Hiram, GA 30141-7813

Phone

(678) 602-9709

Fax

(678) 928-9499

NPI assigned

Jul 8, 2010

Last updated

Jun 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sha-Rhonda Michea Davis, LCSW, SSW

Title

Owner

Phone

(678) 602-9709

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1548572415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1365",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301411365",
            "telephone_number": "678-602-9709",
            "fax_number": "678-928-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 WENDY BAGWELL PKWY",
            "address_2": "SUITE 812",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301417813",
            "telephone_number": "678-602-9709",
            "fax_number": "678-928-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED2CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHA-RHONDA",
        "authorized_official_middle_name": "MICHEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-602-9709",
        "authorized_official_credential": "LCSW, SSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Trio LLC
• Ingrid A Ellison, M.D.
• Benjamin Emareyo
• Embrace Counseling and Consulting, LLC
• Kathleen Elizabeth Empen, M.D.
• Kizzie Idella Enoch
• Matthew Lee Estes, NP-C
• Kelley Lyn Etheridge, ATC
• Denise Rae Etter, PT
• Evergreen Counseling, LLC

• Clinical Social Worker in Hiram, GA
• Providers in Hiram, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.