Provider Demographics
NPI:1366445272
Name:POWELL, ADAM DOUGLASS (LSCSW)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:DOUGLASS
Last Name:POWELL
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 SW QUINTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1179
Mailing Address - Country:US
Mailing Address - Phone:785-233-1731
Mailing Address - Fax:785-233-1731
Practice Address - Street 1:319 SW QUINTON AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1179
Practice Address - Country:US
Practice Address - Phone:785-233-1731
Practice Address - Fax:785-233-1731
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical