Powell, Jackie

Powell, Jackie is an individual health care provider with primary practice located at 6262 E Broadway Rd Suite 101, Mesa AZ 85206-6101. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Powell, Jackie can be contacted via phone (480) 664-4053.

Contact Information

Primary practice address
6262 E Broadway Rd Suite 101 Mesa AZ 85206-6101
Phone: (480) 664-4053
Fax: (480) 452-0883
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC-15108 Arizona

Profile Details

NPI number 1366895427
LBN Legal business name Powell, Jackie
Credentials MAC, LISAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2016
Last updated Sep 28th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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