MEDICARE: MS. BARBARA A POWERS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	1999135867	MO

General Provider Information

NPI Number	:	1023219979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA A POWERS LPC

Provider Business Mailing Address
First Line	:	800 VERNON ST
Second Line	:
City	:	EAST ALTON
State	:	IL
Zip	:	62024-1660
Country	:	US
Telephone Number	:	314-913-3629
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 HUBER PARK CT
Second Line	:	ST.E 101
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-8683
Country	:	US
Telephone Number	:	314-913-3629
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	07/08/2007

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