Individual
MR. EVAN MCCOY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCA, LCASA
Contact information
Practice address
4140 CHERRY ST, WINSTON SALEM, NC 27105-2536
(336) 306-9620
(336) 245-8839
Mailing address
4140 CHERRY ST, WINSTON SALEM, NC 27105-2536
(336) 306-9620
(336) 245-8839
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2913-A
NC
101YP2500X
Professional Counselor
Primary
A11130
NC
Other
Enumeration date
12/06/2012
Last updated
01/13/2015
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