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General NPI Number Information
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NPI Number | 1235708363
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Entity Type | Individual
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Provider Name | ERICA POWELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 103 COUNTRY CLUB DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-7603
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Country | US
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Telephone | 910-400-7002
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746724
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City | ATLANTA
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State | GA
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Zip | 30374-6724
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Country | US
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Telephone | 129-290-3733
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C016506
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License Number State | NC
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