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General NPI Number Information
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NPI Number | 1790172468
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Entity Type | Organization
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Legal Business Name | KATHERINE POWELL, LCSW MPH, LLC
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 72 NORTH ST STE 304
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City | DANBURY
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State | CT
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Zip | 06810-5653
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Country | US
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Telephone | 203-942-9830
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Fax |
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Provider Business Mailing Address
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Address Line | 907 LIVINGSTON RD
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City | ELIZAVILLE
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State | NY
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Zip | 12523-1022
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Country | US
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Telephone | 203-942-9830
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE S POWELL
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Credential | LCSW MPH
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Telephone | 203-942-9830
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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 | 05556
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License Number State | CT
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