Brooke Nicole Powell, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

72602 Issued in TX

Practice address

1804 Glenmore Ave
Fort Worth, TX 76102-1509

Phone

(817) 368-9679

NPI assigned

Sep 3, 2020

Last updated

Sep 3, 2020By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1932713385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 GLENMORE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761021509",
            "telephone_number": "817-368-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 GLENMORE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761021509",
            "telephone_number": "817-368-9679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "BROOKE",
        "middle_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "72602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "277f4278-cc86-4906-af18-43411108c3d3",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1804 Glenmore Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761021509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Powell Davis, MS, RD, LD
• Allie Jill Powell
• Allison Virginia Powell
• Amber Lushun Powell
• Ashley L Powell, RN
• Buffy Powell, NP
• David R Powell
• Jake Powell
• Kailee Powell
• Kayla Powell

• Mental Health Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.