Individual
JG MWAMBA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
1913 LAMAR ST, DURHAM, NC 27705-3310
(919) 286-1509
(910) 897-2009
Mailing address
1913 LAMAR ST, DURHAM, NC 27705-3310
(919) 286-1509
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29168
NC
Other
Enumeration date
11/18/2024
Last updated
03/27/2025
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