Provider Demographics
NPI:1578691655
Name:POWELL, JENNIFER SCHOOLEY (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SCHOOLEY
Last Name:POWELL
Suffix:
Gender:F
Credentials:MA, LMFT
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 663
Mailing Address - Street 2:
Mailing Address - City:BLUE LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95525-0663
Mailing Address - Country:US
Mailing Address - Phone:707-502-6564
Mailing Address - Fax:
Practice Address - Street 1:2413 2ND ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0811
Practice Address - Country:US
Practice Address - Phone:707-502-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor