Provider Demographics
NPI:1639051600
Name:POWELL, MANUEL
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:POWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 SHEFFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1976
Mailing Address - Country:US
Mailing Address - Phone:757-537-9229
Mailing Address - Fax:757-537-9229
Practice Address - Street 1:826 SHEFFIELD ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-1976
Practice Address - Country:US
Practice Address - Phone:757-537-9229
Practice Address - Fax:757-537-9229
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704017866101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health