Provider Demographics
NPI:1659644847
Name:POWELL, KATHLEEN FRANCES (PHD, LPC, LPCS)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:FRANCES
Last Name:POWELL
Suffix:
Gender:F
Credentials:PHD, LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 FORT JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078-8899
Mailing Address - Country:US
Mailing Address - Phone:803-318-7336
Mailing Address - Fax:
Practice Address - Street 1:1599 FORT JACKSON RD
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-8899
Practice Address - Country:US
Practice Address - Phone:803-318-7336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2582101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional