MEDICARE: LAUREN POWERS

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	LGP8312	MD

General Provider Information

NPI Number	:	1407310618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN POWERS

Provider Business Mailing Address
First Line	:	7524 MAIN ST STE 101
Second Line	:
City	:	SYKESVILLE
State	:	MD
Zip	:	21784-7594
Country	:	US
Telephone Number	:	410-746-5868
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 ELLICOTT CENTER DR STE 105
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4666
Country	:	US
Telephone Number	:	410-746-5868
Fax Number	:

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

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	01/22/2019

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Directions to “ LAUREN POWERS ” Practice Location

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