Healthcare Provider Details

I. General information

NPI: 1144016502
Provider Name (Legal Business Name): VICTORIA MARIA POWERS NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA MARIA CARDENAS

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 BOSTWICK AVE NE TRIO STUDENT SUPPORT SERVICES
GRAND RAPIDS MI
49503-3201
US

IV. Provider business mailing address

1117 MAPLEGROVE DR NW
GRAND RAPIDS MI
49504-3837
US

V. Phone/Fax

Practice location:
  • Phone: 616-234-4150
  • Fax:
Mailing address:
  • Phone: 616-366-7397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401224782
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: