Provider Demographics
NPI:1588713200
Name:POWELL, KYMBERLY MACHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:KYMBERLY
Middle Name:MACHELLE
Last Name:POWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2254 DANBERRY CT
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-3257
Mailing Address - Country:US
Mailing Address - Phone:571-228-9992
Mailing Address - Fax:
Practice Address - Street 1:21945 THREE NOTCH RD STE 102A
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-1563
Practice Address - Country:US
Practice Address - Phone:240-788-8918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040105991041C0700X
DCLC50080781041C0700X
1041S0200X, 101YA0400X
MD192371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)