Provider Demographics
NPI:1346588381
Name:POWELL, JINNELLE V (MS, LPC)
Entity type:Individual
Prefix:
First Name:JINNELLE
Middle Name:V
Last Name:POWELL
Suffix:
Gender:
Credentials:MS, LPC
Other - Prefix:
Other - First Name:JINNELLE
Other - Middle Name:VERONIQUE
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4646 CORONA DR STE 216
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4386
Mailing Address - Country:US
Mailing Address - Phone:361-945-3084
Mailing Address - Fax:361-724-3306
Practice Address - Street 1:4646 CORONA DR STE 216
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4386
Practice Address - Country:US
Practice Address - Phone:361-945-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12129101YA0400X
TX69081101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)