Healthcare Provider Details

I. General information

NPI: 1558271742
Provider Name (Legal Business Name): CARRIE L POWELL LCSWI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12032 FIREMANS CANAL DR
CLERMONT FL
34711-9338
US

IV. Provider business mailing address

12032 FIREMANS CANAL DR
CLERMONT FL
34711-9338
US

V. Phone/Fax

Practice location:
  • Phone: 352-267-3192
  • Fax:
Mailing address:
  • Phone: 352-267-3192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW21775
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: