Individual
TALLIBAH ANGELA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
155 WILLOWBROOK BLVD STE 110, WAYNE, NJ 07470-7033
(862) 277-0584
Mailing address
398 HIGH ST FL 1, ORANGE, NJ 07050-1921
(973) 519-7609
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06595600
NJ
1041C0700X
Clinical Social Worker
099943-01
NY
Other
Enumeration date
12/04/2023
Last updated
01/23/2026
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