Provider Demographics
NPI:1295431906
Name:POWELL, CINDI ROSE (MED, NCC, LPC)
Entity type:Individual
Prefix:MISS
First Name:CINDI
Middle Name:ROSE
Last Name:POWELL
Suffix:
Gender:F
Credentials:MED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WILKES BARRE ST FL 1
Mailing Address - Street 2:
Mailing Address - City:WHITE HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:18661-1418
Mailing Address - Country:US
Mailing Address - Phone:570-926-6730
Mailing Address - Fax:
Practice Address - Street 1:301 WILKES BARRE ST FL 1
Practice Address - Street 2:
Practice Address - City:WHITE HAVEN
Practice Address - State:PA
Practice Address - Zip Code:18661-1418
Practice Address - Country:US
Practice Address - Phone:570-926-6730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty