Provider Demographics
NPI:1316024672
Name:POWELL, LINDA LEE (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:POWELL
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 E 200 N
Mailing Address - Street 2:BEAR RIVER MENTAL HEALTH
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4034
Mailing Address - Country:US
Mailing Address - Phone:435-752-0750
Mailing Address - Fax:435-752-7433
Practice Address - Street 1:90 E 200 N
Practice Address - Street 2:BEAR RIVER MENTAL HEALTH
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-4034
Practice Address - Country:US
Practice Address - Phone:435-752-0750
Practice Address - Fax:435-752-7433
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT135671-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional