Provider Demographics
NPI:1760701643
Name:POWELL, KAREN NICOLE (LMHC12273 LCMHC11423)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:NICOLE
Last Name:POWELL
Suffix:
Gender:F
Credentials:LMHC12273 LCMHC11423
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4142
Mailing Address - Country:US
Mailing Address - Phone:919-808-2625
Mailing Address - Fax:
Practice Address - Street 1:918 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4142
Practice Address - Country:US
Practice Address - Phone:919-808-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health