Provider Demographics
NPI:1912053786
Name:RESTREPO-POWERS, ADRIANA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:
Last Name:RESTREPO-POWERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BOSTON ST STE 2
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2817
Mailing Address - Country:US
Mailing Address - Phone:203-907-5995
Mailing Address - Fax:203-453-5684
Practice Address - Street 1:35 BOSTON ST STE 2
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2817
Practice Address - Country:US
Practice Address - Phone:203-907-5995
Practice Address - Fax:203-453-5684
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001536106H00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1912053786Medicaid