Provider Demographics
NPI:1629389242
Name:HUNTER POWELL, TERRI GLADYS (LLPC)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:GLADYS
Last Name:HUNTER POWELL
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:MS
Other - First Name:TERRI
Other - Middle Name:GLADYS
Other - Last Name:HUNTER POWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLPC
Mailing Address - Street 1:5555 CONNER ST
Mailing Address - Street 2:SUITE 1611
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-3448
Mailing Address - Country:US
Mailing Address - Phone:313-923-8058
Mailing Address - Fax:313-923-8143
Practice Address - Street 1:5555 CONNER ST
Practice Address - Street 2:SUITE 1611
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-3448
Practice Address - Country:US
Practice Address - Phone:313-923-8058
Practice Address - Fax:313-923-8143
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010823101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional