Provider Demographics
NPI:1861706889
Name:POWELL, DUSTI D (MS, TLMFT)
Entity type:Individual
Prefix:MRS
First Name:DUSTI
Middle Name:D
Last Name:POWELL
Suffix:
Gender:F
Credentials:MS, TLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N CHERRY ST STE 225
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-3484
Mailing Address - Country:US
Mailing Address - Phone:913-244-0648
Mailing Address - Fax:
Practice Address - Street 1:110 N CHERRY ST STE 225
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3484
Practice Address - Country:US
Practice Address - Phone:913-244-0648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1144106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist