Provider Demographics
NPI:1457153173
Name:POWELL, SHYLA LOUISE (LMHC)
Entity type:Individual
Prefix:
First Name:SHYLA
Middle Name:LOUISE
Last Name:POWELL
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 NEW GARDEN RD UNIT 387
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2001
Mailing Address - Country:US
Mailing Address - Phone:336-365-1389
Mailing Address - Fax:
Practice Address - Street 1:3502 SHAKER DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9170
Practice Address - Country:US
Practice Address - Phone:336-365-1389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015591-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health