Individual
AMANDA S EVANS POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1577 CONGRESS ST, 1ST FLOOR, PORTLAND, ME 04102-2169
(207) 662-1622
(207) 774-1814
Mailing address
49 CUMMINGS AVE, BUXTON, ME 04093
(207) 650-0625
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LS8751
ME
1041C0700X
Clinical Social Worker
Primary
LC12159
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30427534
—
NH
05
—
432649799
—
ME
Enumeration date
08/21/2007
Last updated
01/22/2019
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