Individual
DR. JENIFER L POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3000 NEW BERN AVE, WAKEMED, RALEIGH, NC 27610-1231
(919) 350-7846
Mailing address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3101
NC
103TB0200X
Cognitive & Behavioral Psychologist
3101
NC
103TC2200X
Clinical Child & Adolescent Psychologist
3101
NC
103TH0100X
Health Service Psychologist
3101
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046PP
BCBS NC
NC
05
—
6000751
—
NC
05
—
6000856
—
NC
Enumeration date
12/16/2005
Last updated
07/11/2016
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