Organization
EMPOWERED MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE DENISE KAZUBA LPC (CLINICAL DIRECTOR)
(703) 975-6351
Entity
Organization
Contact information
Practice address
12605 GLENBROOKE WOODS DR, HERNDON, VA 20171-2122
(703) 975-6351
Mailing address
335 WOOD DALE DR, HENDERSONVILLE, NC 28791-7818
(703) 975-6351
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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