Organization Active NPI

Empowered Change Counseling Service LCC

  • Mental Health Counselor
  • Middletown, OH
National Provider Identifier
1811620768
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
EMPOWERED CHANGE COUNSELING SERVICE LCC
Practice address
3030 Apple Knoll LN
Middletown, OH 45044-7991
Phone
(513) 212-6929
NPI assigned
Jul 7, 2022
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Eric StoneNPI 1265086573
Title
Owner
Phone
(513) 212-6929

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 Counselor 101YM0800X NU Primary

Addresses

Primary practice location

3030 Apple Knoll LN
Middletown, OH 45044-7991

Mailing address

3030 Apple Knoll LN
Middletown, OH 45044-7991
Phone (513) 212-6929

Other identifiers 1

IdentifierTypeStateIssuer
1265086573MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1657152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1811620768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 APPLE KNOLL LN",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450447991",
            "telephone_number": "513-212-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 APPLE KNOLL LN",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450447991",
            "telephone_number": "513-212-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED CHANGE COUNSELING SERVICE LCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-212-6929"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265086573",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.