Healthcare Provider Details

I. General information

NPI: 1023219979
Provider Name (Legal Business Name): BARBARA A POWERS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HUBER PARK CT ST.E 101
WELDON SPRING MO
63304-8683
US

IV. Provider business mailing address

800 VERNON ST
EAST ALTON IL
62024-1660
US

V. Phone/Fax

Practice location:
  • Phone: 314-913-3629
  • Fax:
Mailing address:
  • Phone: 314-913-3629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1999135867
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: