Healthcare Provider Details

I. General information

NPI: 1033427182
Provider Name (Legal Business Name): CYNTHIA ANN POWELL PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4608 CEDAR AVE STE 100
WILMINGTON NC
28403-4429
US

IV. Provider business mailing address

4608 CEDAR AVE STE 100
WILMINGTON NC
28403-4429
US

V. Phone/Fax

Practice location:
  • Phone: 910-833-5231
  • Fax: 888-253-3674
Mailing address:
  • Phone: 910-833-5231
  • Fax: 888-253-3674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4766
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: