Provider Demographics
NPI:1811031909
Name:POWELL, PATRICIA LEIGH (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LEIGH
Last Name:POWELL
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3536 BRAMBLETON AVENUE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018
Mailing Address - Country:US
Mailing Address - Phone:540-989-7700
Mailing Address - Fax:
Practice Address - Street 1:3536 BRAMBLETON AVENUE
Practice Address - Street 2:SUITE 4
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-989-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health