Provider Demographics
NPI:1144016502
Name:POWERS, VICTORIA MARIA (NCC, LPC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MARIA
Last Name:POWERS
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:MARIA
Other - Last Name:CARDENAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1117 MAPLEGROVE DR NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-3837
Mailing Address - Country:US
Mailing Address - Phone:616-366-7397
Mailing Address - Fax:
Practice Address - Street 1:143 BOSTWICK AVE NE
Practice Address - Street 2:TRIO STUDENT SUPPORT SERVICES
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-3201
Practice Address - Country:US
Practice Address - Phone:616-234-4150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401224782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional