Individual provider Active NPI

Carisa Ozell Powell, LPC-MHSP

  • Professional Counselor
  • Chattanooga, TN
National Provider Identifier
1629703020
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5468 Issued in TN
Practice address
9104 Glouster LN
Chattanooga, TN 37416-1504
Phone
(423) 645-8664
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 5468 TN Primary

Addresses

Primary practice location

9104 Glouster LN
Chattanooga, TN 37416-1504

Mailing address

9104 Glouster LN
Chattanooga, TN 37416-1504
Phone (423) 645-8664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5468TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1629703020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 GLOUSTER LN",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374161504",
            "telephone_number": "423-645-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 GLOUSTER LN",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374161504",
            "telephone_number": "423-645-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "CARISA",
        "middle_name": "OZELL",
        "credential": "LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.