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NPI Code Detail

MEDICARE: JENNIFER SCHOOLEY POWELL M.A., LMFT

MEDICARE: JENNIFER SCHOOLEY POWELL M.A., LMFT
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
1101Y00000XCounselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578691655
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER SCHOOLEY POWELL M.A., LMFT
Provider Business Mailing Address
First Line : PO BOX 663
Second Line :
City : BLUE LAKE
State : CA
Zip : 95525-0663
Country : US
Telephone Number : 707-502-6564
Fax Number :
Provider Business Practice Location Address
First Line : 2413 2ND ST
Second Line :
City : EUREKA
State : CA
Zip : 95501-0811
Country : US
Telephone Number : 707-502-6564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 04/10/2019

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