Healthcare Provider Details

I. General information

NPI: 1821710096
Provider Name (Legal Business Name): POWERS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 PRESCOTT DR
PRESCOTT AZ
86301-4405
US

IV. Provider business mailing address

361 PRESCOTT DR
PRESCOTT AZ
86301-4405
US

V. Phone/Fax

Practice location:
  • Phone: 720-300-0869
  • Fax:
Mailing address:
  • Phone: 720-300-0869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER POWERS
Title or Position: OWNER
Credential: LCSW
Phone: 720-300-0869