Provider Demographics
NPI:1932715471
Name:POWELL-LEWIS, RAQUEL (LPC)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:POWELL-LEWIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5123 PRINCE WILLIAM WAY
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-8304
Mailing Address - Country:US
Mailing Address - Phone:513-706-9594
Mailing Address - Fax:
Practice Address - Street 1:1435 VINE ST APT 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-7094
Practice Address - Country:US
Practice Address - Phone:513-599-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1000190101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor