Individual
CODY RANDALL POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8410087-3502
UT
1041C0700X
Clinical Social Worker
LSW.0009921562
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14457933
CAQH
—
Enumeration date
01/26/2012
Last updated
12/12/2019
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