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General NPI Number Information
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NPI Number | 1760520860
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Entity Type | Individual
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Provider Name | RYLAND BOULDIN POWELL SR. LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 74 PARKER AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-1746
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Country | US
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Telephone | 973-763-2155
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Fax | 973-763-6225
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Provider Business Mailing Address
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Address Line | 74 PARKER AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-1746
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Country | US
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Telephone | 973-763-2155
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Fax | 973-763-6225
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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 | 44SC00017300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37F100055500
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License Number State | NJ
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