Provider Demographics
NPI:1215122874
Name:POWELL, CYNTHIA (LMHC, LCDP)
Entity type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:LMHC, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ASHTON PKWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-4827
Mailing Address - Country:US
Mailing Address - Phone:401-439-7457
Mailing Address - Fax:
Practice Address - Street 1:17 ASHTON PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-4827
Practice Address - Country:US
Practice Address - Phone:401-439-7457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00484101YA0400X
RIMHC00628101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI30343OtherBLUE CROSS CRISIS