Individual provider · Type 1 NPI

Jackie Powell, MAC, LISAC

Addiction (Substance Use Disorder) Counselor · Mesa, AZ

NPI number 1366895427 Active

Practice location

6262 E Broadway Rd, Suite 101
Mesa, AZ 85206-6101

Fax (480) 452-0883

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XLISAC-15108 (AZ)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1366895427

Jackie Powell, MAC, LISAC's National Provider Identifier is 1366895427, issued on Jul 13, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Mesa, AZ. The record was last updated on Sep 28, 2018.