Provider Demographics
NPI:1598114613
Name:POWELL, BARBARA A (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:POWELL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:MI
Mailing Address - Zip Code:49635-9048
Mailing Address - Country:US
Mailing Address - Phone:231-930-8014
Mailing Address - Fax:
Practice Address - Street 1:512 S UNION ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-3247
Practice Address - Country:US
Practice Address - Phone:231-941-6550
Practice Address - Fax:231-941-8981
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004343101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional