MEDICARE: CYNTHIA POWELL LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	13652	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	85137L	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1083747679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA POWELL LPC

Provider Business Mailing Address
First Line	:	PO BOX 2127
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77410-2127
Country	:	US
Telephone Number	:	281-477-6363
Fax Number	:	281-477-6356

Provider Business Practice Location Address
First Line	:	12345 JONES RD
Second Line	:	SUITE 110
City	:	HOUSTON
State	:	TX
Zip	:	77070-4855
Country	:	US
Telephone Number	:	281-477-6363
Fax Number	:	281-477-6356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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Directions to “ CYNTHIA POWELL LPC” Practice Location

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