Healthcare Provider Details

I. General information

NPI: 1154109650
Provider Name (Legal Business Name): LAUREN POWELL M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3974 SPRINGFIELD RD STE A
GLEN ALLEN VA
23060-4119
US

IV. Provider business mailing address

1108 BUCKINGHAM STATION DR APT 1C
MIDLOTHIAN VA
23113-4292
US

V. Phone/Fax

Practice location:
  • Phone: 804-495-8661
  • Fax:
Mailing address:
  • Phone: 443-786-9992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0704016216
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: