Provider Demographics
NPI:1073639142
Name:POWELL, PATRICIA MONROE (LPC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MONROE
Last Name:POWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WALTERS CT
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-7581
Mailing Address - Country:US
Mailing Address - Phone:910-582-4253
Mailing Address - Fax:
Practice Address - Street 1:108 WALTERS CT
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-7581
Practice Address - Country:US
Practice Address - Phone:910-582-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6511101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6511OtherLPC-LICENSE NUMBER