Provider Demographics
NPI:1619275260
Name:POWELL, PAUL MARTIN (LPC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:MARTIN
Last Name:POWELL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 FALLING CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601
Mailing Address - Country:US
Mailing Address - Phone:828-381-5144
Mailing Address - Fax:
Practice Address - Street 1:452 HARPER AVE NW STE A
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5072
Practice Address - Country:US
Practice Address - Phone:828-391-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8472101YM0800X
NCLPCA-A8472101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health