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Individual

ANNIE M POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCDC, MHPS, RSPS

Contact information

Practice address
1236 SOUTHRIDGE CT STE 207, HURST, TX 76053-4284
(877) 257-2282
(877) 257-2282
Mailing address
PO BOX 3472, COPPELL, TX 75019-9472
(214) 883-9520

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
171400000X
Health & Wellness Coach
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
175T00000X
Peer Specialist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
380106001
TX
Enumeration date
04/16/2018
Last updated
05/13/2024
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