Organization
EMPOWERMENT DIVERSITY AND INCLUSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LARRY THOMPSON LCSW (FOUNDER)
(732) 389-0697
Entity
Organization
Contact information
Practice address
615 HOPE RD BLDG 5B2ND, EATONTOWN, NJ 07724-1277
(732) 389-0697
(732) 389-0611
Mailing address
615 HOPE RD BLDG 5B2ND, EATONTOWN, NJ 07724-1277
(732) 389-0697
(732) 389-0611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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