Penni Ackerman Powell, M.S.W., L.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C000536 Issued in NC

Practice address

1717 Cleveland Ave
Charlotte, NC 28203-4735

Phone

(704) 372-8004

NPI assigned

Jun 2, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Penni Ackerman Wallas Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1477591550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 DILWORTH RD W",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035732",
            "telephone_number": "704-343-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 CLEVELAND AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034735",
            "telephone_number": "704-372-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "PENNI",
        "middle_name": "ACKERMAN",
        "name_prefix": "Ms.",
        "credential": "M.S.W., L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000536",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NC",
            "identifier": "8538A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNI",
            "last_name": "WALLAS",
            "middle_name": "ACKERMAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kevin A. Powell, M.D.
• Lindsey Powell, PA-C
• Melanie V Powell, PH.D.
• Michelle Franklin Powell, LCSW
• Molly Aaron Powell, MD
• Randolph Lee Powell, RPH
• Ryland Bouldin Powell Jr., LCSW
• Stephen Barnes Powell II, PT, DPT
• Stephen H Powell, MD
• Thomas Gage Powell, DO

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.