Provider Demographics
NPI:1831155423
Name:POWELL, LINDA CARROLL (MS, LCPC, NCC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CARROLL
Last Name:POWELL
Suffix:
Gender:F
Credentials:MS, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5220
Mailing Address - Country:US
Mailing Address - Phone:301-514-1602
Mailing Address - Fax:413-812-8499
Practice Address - Street 1:252 E 6TH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5220
Practice Address - Country:US
Practice Address - Phone:301-514-1602
Practice Address - Fax:413-812-8499
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1213101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCM3560001OtherCAREFIRST DC PROVIDER #
MD61323604OtherCAREFIRST MD RENDERING#
MD7157382OtherAETNA PROVIDER #
MD1Y19LCOtherCAREFIRST MD PROVIDER #
MD6273148OtherUBH PROVIDER #