Provider Demographics
NPI:1700169281
Name:POWRIE, CALLA MARIE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CALLA
Middle Name:MARIE
Last Name:POWRIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CRESCENT
Other - Middle Name:
Other - Last Name:COUNSELING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12128 N DIVISION ST # 192
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1905
Mailing Address - Country:US
Mailing Address - Phone:509-724-0153
Mailing Address - Fax:
Practice Address - Street 1:123 W CASCADE WAY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6017
Practice Address - Country:US
Practice Address - Phone:509-724-0153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60501097101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health