Active NPI
Empower Support Services
- Community/Behavioral Health Agency
- Fairfax, VA
National Provider Identifier
1689584856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- EMPOWER SUPPORT SERVICES
- Practice address
- 11130 Fairfax Blvd Ste 200
Fairfax, VA 22030-5035 - Phone
- (301) 556-8301
- NPI assigned
- Sep 10, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Banguket Perez
- Title
- Ceo
- Phone
- (301) 556-8301
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
11130 Fairfax Blvd Ste 200
Fairfax, VA 22030-5035
Mailing address
12849 Longford Glen Dr
Germantown, MD 20874-4107
Phone (301) 556-8301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1689584856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12849 LONGFORD GLEN DR",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208744107",
"telephone_number": "301-556-8301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11130 FAIRFAX BLVD STE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220305035",
"telephone_number": "301-556-8301"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMPOWER SUPPORT SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-10",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A",
"authorized_official_last_name": "PEREZ",
"authorized_official_first_name": "BANGUKET",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "301-556-8301"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
- Katelin Jackfert Emory
- Empathy Health Services, Inc
- Empire Home Health Services LLC
- Empower Chiropractic LLC
- Empower Hand Therapy and Rehabilitation LLC
- Empowering Voices ABA LLC
- Enabling Change Rebuilding Communities Each Counseling Services
- Benjamin Isaac Enav, M.D.
- Samim Enayat, MD
- Carson Scott Endorf, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.