Healthcare Provider Details

I. General information

NPI: 1932037371
Provider Name (Legal Business Name): ROBERT POWELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 W COLLEGE ST
TROY MO
63379-1101
US

IV. Provider business mailing address

9618 HAROLD DR
SAINT LOUIS MO
63134-4215
US

V. Phone/Fax

Practice location:
  • Phone: 636-528-1488
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: