Individual
MR. JEFFREY POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ADC-T
Contact information
Practice address
705 42ND AVE N, MINNEAPOLIS, MN 55412-1711
(612) 504-2047
(952) 516-5161
Mailing address
1314 MARQUETTE AVE APT 2408, MINNEAPOLIS, MN 55403-4133
(763) 290-2736
(952) 516-5161
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
171400000X
Health & Wellness Coach
—
—
175T00000X
Peer Specialist
Primary
—
—
177F00000X
Lodging Provider
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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