Empowered Mind & Wellness

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

EMPOWERED MIND & WELLNESS

Practice address

805 Harmon Dr Apt B6
Valdosta, GA 31601-8477

Phone

(229) 232-9601

NPI assigned

Nov 14, 2022

Organization subpart

No

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

Authorized official

Name

Ebonique Vernee Martin, MASTERS DEGREE MFTNPI 1083912117

Title

LMFT/Therapist

Phone

(229) 232-9601

Specialties & licenses 1

Addresses

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

• Ebonique Martin, LMFT

  • Marriage & Family Therapist
  • Valdosta, GA
  • NPI 1083912117
  NPD Authorized official

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1801504246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 HARMON DR APT B6",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316018477",
            "telephone_number": "229-232-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 HARMON DR APT B6",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316018477",
            "telephone_number": "229-232-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED MIND & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "EBONIQUE",
        "authorized_official_middle_name": "VERNEE",
        "authorized_official_title_or_position": "LMFT/THERAPIST",
        "authorized_official_telephone_number": "229-232-9601",
        "authorized_official_credential": "MASTERS DEGREE MFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Valdosta, GA
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.