Provider Demographics
NPI:1093252355
Name:POWER, EILEEN C (MSED, LPC)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:C
Last Name:POWER
Suffix:
Gender:F
Credentials:MSED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 W 18TH ST
Mailing Address - Street 2:APT 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4537
Mailing Address - Country:US
Mailing Address - Phone:917-842-5337
Mailing Address - Fax:917-591-7834
Practice Address - Street 1:8700 E VIA DE VENTURA STE 280
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4541
Practice Address - Country:US
Practice Address - Phone:480-210-7266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZLPC-22145101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program