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Organization

POWELL THERAPEUTICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS PATRICE RENA POWELL LPC, LSATP, CSAC (OWNER)
(757) 254-4644
Entity
Organization

Contact information

Practice address
1805 CHANTILLY ST STE 126, RICHMOND, VA 23230-3501
(757) 254-4644
(804) 621-7103
Mailing address
101 NEW HARVEST DR, HENRICO, VA 23231-5172
(757) 254-4644
(804) 621-7103

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
03/25/2024
Last updated
12/10/2024
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