Provider Demographics
NPI:1598044307
Name:POWELL, MARGARET PEEK (LPC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:PEEK
Last Name:POWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MARINERS DR SUITE D
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548
Mailing Address - Country:US
Mailing Address - Phone:912-510-0669
Mailing Address - Fax:
Practice Address - Street 1:100 MARINERS DR. SUITE D
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548
Practice Address - Country:US
Practice Address - Phone:912-510-0669
Practice Address - Fax:706-256-3264
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002912101Y00000X
GALPC010536101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor