Provider Demographics
NPI:1336878545
Name:POWELL COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:POWELL COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:865-328-2376
Mailing Address - Street 1:7311 CLINTON HWY STE B
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5224
Mailing Address - Country:US
Mailing Address - Phone:865-328-2376
Mailing Address - Fax:865-409-5849
Practice Address - Street 1:7311 CLINTON HWY STE B
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-5224
Practice Address - Country:US
Practice Address - Phone:865-328-2376
Practice Address - Fax:865-409-5849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ037767Medicaid