MEDICARE: VALERIE L POWELL QMHS

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	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1679297774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE L POWELL QMHS

Provider Business Mailing Address
First Line	:	5834 MONROE ST STE A
Second Line	:
City	:	SYLVANIA
State	:	OH
Zip	:	43560-2265
Country	:	US
Telephone Number	:	419-304-3937
Fax Number	:

Provider Business Practice Location Address
First Line	:	2053 N 14TH ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43620-1912
Country	:	US
Telephone Number	:	419-304-3937
Fax Number	:

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

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	01/08/2025

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