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General NPI Number Information
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NPI Number | 1417667973
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Entity Type | Individual
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Provider Name | MATTHEW POWERY LPC
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Gender | Male
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Dates
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Enumeration Date | 11/24/2022
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Last Update Date | 11/24/2022
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Provider Practice Location Address
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Address Line | 3235 N 3RD ST
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City | HARRISBURG
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State | PA
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Zip | 17110-1308
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Country | US
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Telephone | 717-234-3839
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Fax |
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Provider Business Mailing Address
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Address Line | 181 MELBOURNE LN
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City | MECHANICSBURG
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State | PA
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Zip | 17055-6624
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Country | US
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Telephone | 423-303-8634
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC015055
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License Number State | PA
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