Provider Demographics
NPI:1518779370
Name:POWERS, CAROL (MS, LPC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 KELLEYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-3910
Mailing Address - Country:US
Mailing Address - Phone:678-410-3109
Mailing Address - Fax:
Practice Address - Street 1:1257 COMMERCIAL DR SW STE D
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5991
Practice Address - Country:US
Practice Address - Phone:678-252-9057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional