Provider Demographics
NPI:1942340054
Name:POWELL, LUCY E (LCSW)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:E
Last Name:POWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:479 MONTICELLO PARK
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-3073
Mailing Address - Country:US
Mailing Address - Phone:979-733-3232
Mailing Address - Fax:
Practice Address - Street 1:479 MONTICELLO PARK
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77302-3073
Practice Address - Country:US
Practice Address - Phone:979-733-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC104051041C0700X
TX182221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119746903Medicaid
MS200004732Medicaid