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Organization

EMPOWERED CHANGE: COUNSELING & EDUCATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY A WIENECKE MA, LPC, LAC (PRESIDENT)
(720) 443-1278
Entity
Organization

Contact information

Practice address
800 WASHINGTON AVE, SUITE D, GOLDEN, CO 80401
(720) 443-1278
(720) 368-5056
Mailing address
800 WASHINGTON AVE APT D, GOLDEN, CO 80401-5815
(720) 443-1278

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor

Other

Enumeration date
11/12/2018
Last updated
11/12/2018
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