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General NPI Number Information
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NPI Number | 1750612396
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Entity Type | Organization
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Legal Business Name | POWELL COUNSELING CENTER, PLLC
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 2924 FOX PL
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City | MOORESBORO
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State | NC
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Zip | 28114-9793
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Country | US
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Telephone | 828-429-1240
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Fax | 828-657-5923
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Provider Business Mailing Address
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Address Line | 2924 FOX PL
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City | MOORESBORO
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State | NC
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Zip | 28114-9793
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Country | US
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Telephone | 828-429-1240
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Fax | 828-657-5923
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Authorized Official
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Title or Position | OWNER
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Name | JAMES E. POWELL
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Credential | LPC,LCAS,
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Telephone | 828-429-1240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | LPC 3658
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License Number State | NC
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