Provider Demographics
NPI:1275728545
Name:WOODBURY, PATRICIA POWELL (ED D,LPC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:POWELL
Last Name:WOODBURY
Suffix:
Gender:F
Credentials:ED D,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 INDIAN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1737
Mailing Address - Country:US
Mailing Address - Phone:757-930-2755
Mailing Address - Fax:757-881-5088
Practice Address - Street 1:47 INDIAN SPRINGS DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1737
Practice Address - Country:US
Practice Address - Phone:757-930-2755
Practice Address - Fax:757-881-5088
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional