Provider Demographics
NPI:1427692920
Name:POWERS, CHERYL L (LPCA, NCC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:POWERS
Suffix:
Gender:F
Credentials:LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 J N PEASE PL STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4509
Mailing Address - Country:US
Mailing Address - Phone:980-313-3020
Mailing Address - Fax:704-980-8023
Practice Address - Street 1:1909 J N PEASE PL STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4509
Practice Address - Country:US
Practice Address - Phone:980-313-3020
Practice Address - Fax:704-980-8023
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15314101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health