Provider Demographics
NPI:1265236889
Name:POWERS, LEA
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:POWERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15010 S RAVINIA AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-5353
Mailing Address - Country:US
Mailing Address - Phone:708-971-0470
Mailing Address - Fax:
Practice Address - Street 1:15010 S RAVINIA AVE STE 12
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-5353
Practice Address - Country:US
Practice Address - Phone:708-971-0470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor