| Mr Wayne Oliver Powell, LPC | |
|
43565 Ahlea Ln, South Riding, VA 20152-4800 | |
| (855) 326-4673 | |
| Not Available |
| Full Name | Mr Wayne Oliver Powell |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 18 Years |
| Location | 43565 Ahlea Ln, South Riding, Virginia |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114327699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 0701005499 (Virginia) | Primary |
| 103TC1900X | Psychologist - Counseling | 0701005499 (Virginia) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Brambleton Assessment And Counseling Center | 5597028514 | 3 |
| Mindful Healing Inc | 3274800750 | 2 |
| Entity Name | Mindful Healing Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174984348 PECOS PAC ID: 3274800750 Enrollment ID: O20170605002211 |
| Entity Name | Brambleton Assessment and Counseling Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194142836 PECOS PAC ID: 5597028514 Enrollment ID: O20180404001466 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Wayne Oliver Powell, LPC 3536 Brambleton Ave., S.w., Suite 3, Brambleton Assessment & Counseling Center, Roanoke, VA 24018-3536 Ph: (540) 537-9834 | Mr Wayne Oliver Powell, LPC 43565 Ahlea Ln, South Riding, VA 20152-4800 Ph: (855) 326-4673 |
Molly Chaloner Mastoras, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 43130 Amberwood Plz, Suite 140, South Riding, VA 20152 Phone: 703-348-0030 Fax: 703-542-7770 |
Brandon Tolley, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 43130 Amberwood Plz Ste 140, South Riding, VA 20152 Phone: 703-348-0030 |