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Individual
SHANNON M POWELL
Active
Individual
SHANNON M POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C0600565
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.140947
OH
101YP2500X
Professional Counselor
Primary
E.0600565-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0183585
—
OH
Enumeration date
11/21/2007
Last updated
03/19/2020
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