Provider Demographics
NPI:1851424592
Name:POWELL, REX (LPC)
Entity Type:Individual
Prefix:
First Name:REX
Middle Name:
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 1:3210 LOUISIANA ST
Mailing Address - Street 2:SUITE 1331
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-6615
Mailing Address - Country:US
Mailing Address - Phone:713-732-6036
Mailing Address - Fax:
Practice Address - Street 1:3210 LOUISIANA ST
Practice Address - Street 2:SUITE 1331
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-6615
Practice Address - Country:US
Practice Address - Phone:713-732-6036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18391101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85120LOtherBCBS