MEDICARE: POWELL MENTAL HEALTH

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1861339814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POWELL MENTAL HEALTH

Provider Business Mailing Address
First Line	:	1080 DAY HILL RD STE 105
Second Line	:
City	:	WINDSOR
State	:	CT
Zip	:	06095-1781
Country	:	US
Telephone Number	:	860-602-8787
Fax Number	:	860-602-8788

Provider Business Practice Location Address
First Line	:	5156 S ORANGE AVE STE C
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-3023
Country	:	US
Telephone Number	:	772-276-9355
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	SOPHIA BROWN
Credential	:
Telephone Number	:	860-602-8787

Provider Enumeration Date	:	04/29/2026
Last Update Date	:	04/29/2026

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Directions to “POWELL MENTAL HEALTH ” Practice Location

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