Provider Demographics
NPI:1205594223
Name:COKEY POWELL PHD TRANSITIONAL COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:COKEY POWELL PHD TRANSITIONAL COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COKEY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-318-4541
Mailing Address - Street 1:4083 SUNBEAM RD APT 510
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-7504
Mailing Address - Country:US
Mailing Address - Phone:619-318-4541
Mailing Address - Fax:
Practice Address - Street 1:4083 SUNBEAM RD APT 510
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-7504
Practice Address - Country:US
Practice Address - Phone:619-318-4541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty