Powell, Jessica
Powell, Jessica is an individual health care provider with primary practice located at 1133 Military Cutoff Rd Suite 200, Wilmington NC 28405-3684. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Powell, Jessica can be contacted via phone (910) 791-5575.Contact Information
Primary practice address
1133 Military Cutoff Rd Suite 200
Wilmington NC 28405-3684
Phone: (910) 791-5575
Fax: (910) 799-5576
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 4808 | North Carolina |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2411 | North Carolina |
Profile Details
| NPI number | 1427034800 |
|---|---|
| LBN Legal business name | Powell, Jessica |
| Credentials | LPA LPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2005 |
| Last updated | Nov 16th, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427034800 | NPPES |
| North Carolina | Other | 344161 | TRICARE |
| North Carolina | MEDICAID | 6107095 | TRICARE |
| North Carolina | Other | 1408C | TRICARE |
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