Provider Demographics
NPI:1174375521
Name:POWERS, KEARA C (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:KEARA
Middle Name:C
Last Name:POWERS
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19707 NW 226TH TER
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-0664
Mailing Address - Country:US
Mailing Address - Phone:352-682-6668
Mailing Address - Fax:
Practice Address - Street 1:19707 NW 226TH TER
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-0664
Practice Address - Country:US
Practice Address - Phone:352-682-6668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW195921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical