Evans Powell, Amanda S

Evans Powell, Amanda S is an individual health care provider with primary practice located at 1577 Congress St 1St Floor, Portland ME 04102-2169. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Evans Powell, Amanda S can be contacted via phone (207) 662-1622.

Contact Information

Primary practice address
1577 Congress St 1St Floor Portland ME 04102-2169
Fax: (207) 774-1814
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X LS8751 Maine
Behavioral Health & Social Service Providers / Clinical 1041C0700X LC12159 Maine

Profile Details

NPI number 1376736579
LBN Legal business name Evans Powell, Amanda S
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2007
Last updated Jan 22nd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376736579 NPPES
New Hampshire MEDICAID 30427534
New Hampshire MEDICAID 432649799

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