Provider Demographics
NPI:1265523542
Name:POWELL, ARDRENA RENEE' (MS, PLPC, CMHT)
Entity type:Individual
Prefix:MS
First Name:ARDRENA
Middle Name:RENEE'
Last Name:POWELL
Suffix:
Gender:F
Credentials:MS, PLPC, CMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 W HAZELWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-5320
Mailing Address - Country:US
Mailing Address - Phone:662-295-9950
Mailing Address - Fax:
Practice Address - Street 1:217 COURT ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-2926
Practice Address - Country:US
Practice Address - Phone:662-494-7060
Practice Address - Fax:662-494-7533
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health