Provider Demographics
NPI:1316034069
Name:POWELL, SANDRA A (RN,LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:A
Last Name:POWELL
Suffix:
Gender:F
Credentials:RN,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:33 HIGHLAND STREET
Mailing Address - Street 2:NEW BRITAIN GENERAL HOSPITAL
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052
Mailing Address - Country:US
Mailing Address - Phone:860-224-9985
Mailing Address - Fax:860-826-4995
Practice Address - Street 1:33 HIGHLAND STREET
Practice Address - Street 2:NEW BRITAIN GENERAL HOSPITAL
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052
Practice Address - Country:US
Practice Address - Phone:860-224-9985
Practice Address - Fax:860-826-4995
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE51354163W00000X
CT001197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist