Provider Demographics
NPI:1043374010
Name:POWERS, SANDRA (LMHC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 GOVERNOR ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3246
Mailing Address - Country:US
Mailing Address - Phone:401-490-3563
Mailing Address - Fax:401-490-3563
Practice Address - Street 1:208 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3246
Practice Address - Country:US
Practice Address - Phone:401-490-3563
Practice Address - Fax:401-490-3563
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILMHC000017106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI30343OtherCRISIS