Keisha Powell, PHD, CAS, ABS, ATS

Primary specialty

SpecialistTaxonomy code 174400000X

License

CAS176247 Issued in FL

Practice address

3 Jessie LN
Broad Brook, CT 06016-9596

Phone

(860) 983-8112

NPI assigned

Apr 25, 2014

Last updated

Oct 9, 2024By the provider in NPPES

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 4

Other names 1

• Dr. Keisha Powell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Powell Therapy Solutions LLC

  • Specialist
  • Broad Brook, CT
  • NPI 1588390058
  NPD Authorized official
• Powell Therapy Solutions, LLC

  • Specialist
  • Broad Brook, CT
  • NPI 1073125688
  NPD Authorized official
• Petalu'Da Autism Services LLC

  • Professional Counselor
  • Vernon, CT
  • NPI 1245578475

  Multi-Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1831519016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 JESSIE LN",
            "city": "BROAD BROOK",
            "state": "CT",
            "postal_code": "060169596",
            "telephone_number": "860-983-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 JESSIE LN",
            "city": "BROAD BROOK",
            "state": "CT",
            "postal_code": "060169596",
            "telephone_number": "860-983-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KEISHA",
        "name_prefix": "Dr.",
        "credential": "PHD, CAS, ABS, ATS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "CAS176247",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "C072017000387",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIAL EDUCATION-AUTISM",
            "identifier": "C072017000387",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080-96340",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFIED SEXOLOGIST",
            "identifier": "23907",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED AUTISM SPECIALIST",
            "identifier": "CAS176247",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEISHA",
            "last_name": "POWELL",
            "prefix": "DR.",
            "credential": "PHD, CAS, ABS, ATS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lindsey Mascaro
• Laura L Pastula, CERTIFIEDBIRTH DOULA
• Matthew Craig Phillips, MA, CCC-SLP
• Powell Therapy Solutions LLC
• Powell Therapy Solutions, LLC
• Heather Elizabeth Rainey
• Serene Psychiatric & Medical Practice PLLC
• Michon Terra, RN BSN
• Tiffany Nicole Visnicky
• You Matter Counseling & Wellness LLC

• Specialist in Broad Brook, CT
• Providers in Broad Brook, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.