Provider Demographics
NPI:1528273893
Name:POWELL, TRINA MICHELLE (LCPC LPC PSYD)
Entity type:Individual
Prefix:DR
First Name:TRINA
Middle Name:MICHELLE
Last Name:POWELL
Suffix:
Gender:F
Credentials:LCPC LPC PSYD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16304 BROOK TRAIL COURT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772
Mailing Address - Country:US
Mailing Address - Phone:301-780-3569
Mailing Address - Fax:301-780-3783
Practice Address - Street 1:6178 OXON HILL ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745
Practice Address - Country:US
Practice Address - Phone:301-567-4751
Practice Address - Fax:301-567-3856
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0740101YP2500X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD64582701OtherCAREFIRST BCBS
DC38100007OtherCAREFIRST BCBS