Provider Demographics
NPI:1407997620
Name:POWELL, CHRISTINA WHITE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:WHITE
Last Name:POWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 VEAZEY ROAD
Mailing Address - Street 2:
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509
Mailing Address - Country:US
Mailing Address - Phone:919-764-2000
Mailing Address - Fax:
Practice Address - Street 1:412 CALDWELL EXT STE D
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-2065
Practice Address - Country:US
Practice Address - Phone:919-357-0691
Practice Address - Fax:919-913-4303
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0043231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0048OtherMAGELLAN BEHAVIORAL HEALT
NC0045OtherMAGELLAN BEHAVIORAL HEALT
NCBCBSOther133A5
NC56-0926931OtherWELLPATH
NC6106035Medicaid
NC133A5OtherBCBS STATE HEALTH PLAN
NC2137952OtherCIGNA-MN BEHAVIORAL
NC133A5OtherBCBS FEDERAL
NC133A5OtherHEALTHCHOICE