Individual
CONNIE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
819 S 2200 W, SYRACUSE, UT 84075-7187
(385) 558-8466
Mailing address
1412 S LEGEND HILLS DR, CLEARFIELD, UT 84015-1587
(385) 558-8466
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
345500-3501
UT
1041C0700X
Clinical Social Worker
Primary
345500-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
—
05
—
876000308007
—
UT
Enumeration date
04/25/2007
Last updated
04/20/2026
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