Provider Demographics
NPI:1477578474
Name:POWELL, RYLAND B JR (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:RYLAND
Middle Name:B
Last Name:POWELL
Suffix:JR
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
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Mailing Address - Street 1:PO BOX 75216
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-0216
Mailing Address - Country:US
Mailing Address - Phone:336-277-1800
Mailing Address - Fax:336-277-6981
Practice Address - Street 1:175 KIMEL PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6951
Practice Address - Country:US
Practice Address - Phone:336-277-1800
Practice Address - Fax:336-277-6981
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical