Powell, Keith A.

Powell, Keith A. is an sole proprietor health care provider with primary practice located at 5935 23Rd St , Vero Beach FL 32966-6403. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Powell, Keith A. can be contacted via phone (772) 794-1367.

Contact Information

Primary practice address
5935 23Rd St Vero Beach FL 32966-6403
Phone: (772) 794-1367
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1992819007
LBN Legal business name Powell, Keith A.
Credentials BCABA, CMHP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2006
Last updated May 3rd, 2018 - 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 1992819007 NPPES
Florida MEDICAID 759468200

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