EMPOWERED2SHIFT (NPI# 1508379967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508379967 |
| Entity Type | Organization |
| Organization Name | EMPOWERED2SHIFT |
| Practice Address |
351 Wagoner Dr Ste 200 Fayetteville NC 28303-4672 |
| Mailing Address |
247 Van Buren Dr Raeford NC 28376-9418 |
| Practice Telephone | 9105878623 |
| Mailing Telephone | 9105878623 |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |
| Authorized Official Name | SHAKEETA TORRES (MENTAL HEALTH COUNSELOR, CEO) |
| Authorized Official Telephone | 9105878623 |
| Authorized Official Credential | MSW, LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
351 WAGONER DR STE 200 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-4672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265082341 | Serene Concepts PC | Clinic/Center | 500 Lanier Ave W Ste 801g, Fayetteville, GA 30214-7642 | 2019-09-19 |
| 1649828971 | Matters of The Mind | Clinic/Center | 1925 Nuthatch Rd, Fayetteville, NC 28304-4766 | 2019-08-29 |
| 1295216562 | Southeast Counseling Services LLC | Clinic/Center | 6405 Camden Rd Ste 109, Fayetteville, NC 28306-7584 | 2018-08-24 |
| 1013251156 | New Day Behavioral Health Center, PC | Clinic/Center | 2139 Valleygate Dr Ste 203, Fayetteville, NC 28304-3666 | 2012-11-15 |
| 1477781300 | Acheving Excellence | Clinic/Center | 1226 Ramsey St, Fayetteville, NC 28301-4402 | 2009-06-30 |
| 1114116944 | Carolina Psychiatry, P.C. | Clinic/Center | 548 Sandhurst Dr, Fayetteville, NC 28304-4426 | 2007-10-17 |
| 1588618292 | Washington Regional Medical System | Clinic/Center | 3211 N North Hills Blvd, Fayetteville, AR 72703 | 2006-05-19 |
| 1831727890 | Aurora Rehabilitation Clinic Pa | Clinic/Center | 509 E Millsap Rd Ste 109, Fayetteville, AR 72703-4862 | 2020-03-27 |
| 1942778691 | New View Behavioral Health Services Pllc | Clinic/Center | 111 Lamon St Ste 222, Fayetteville, NC 28301-4957 | 2018-11-10 |
| 1902306269 | Holos Consulting, LLC | Clinic/Center | 230 W Center St, Fayetteville, AR 72701-5934 | 2018-02-13 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on EMPOWERED2SHIFT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.