Provider Demographics
NPI:1881952463
Name:POWELL, CAROL L (MSW, LISW-S, LCSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:POWELL
Suffix:
Gender:F
Credentials:MSW, LISW-S, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W 5TH ST STE 322
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-1260
Mailing Address - Country:US
Mailing Address - Phone:513-901-1050
Mailing Address - Fax:859-786-1812
Practice Address - Street 1:525 W 5TH ST STE 322
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-1260
Practice Address - Country:US
Practice Address - Phone:513-901-1050
Practice Address - Fax:859-786-1812
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1500840-SUPV1041C0700X
IN34006543A1041C0700X
KY2532911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty