Provider Demographics
NPI:1437846474
Name:POWELL, AMAREE NAKASIA (YOUTH PEER ADVOCATE)
Entity Type:Individual
Prefix:
First Name:AMAREE
Middle Name:NAKASIA
Last Name:POWELL
Suffix:
Gender:F
Credentials:YOUTH PEER ADVOCATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-0608
Mailing Address - Country:US
Mailing Address - Phone:518-483-8980
Mailing Address - Fax:518-483-3383
Practice Address - Street 1:31 6TH ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1246
Practice Address - Country:US
Practice Address - Phone:518-645-6022
Practice Address - Fax:518-483-3833
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist