Provider Demographics
NPI:1295911436
Name:POWELL, LETITIA SHANELL (MA, LPC-S, PHD)
Entity type:Individual
Prefix:MS
First Name:LETITIA
Middle Name:SHANELL
Last Name:POWELL
Suffix:
Gender:F
Credentials:MA, LPC-S, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6046 FM 2920 RD # 625
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2542
Mailing Address - Country:US
Mailing Address - Phone:832-704-1885
Mailing Address - Fax:833-320-8545
Practice Address - Street 1:100 COMMERCIAL CIR BLDG B101
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2212
Practice Address - Country:US
Practice Address - Phone:832-704-1885
Practice Address - Fax:833-320-8545
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61735101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor