Provider Demographics
NPI:1437561362
Name:POWELL, JENNIFER MICHELLE (LCSW BCBA LBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELLE
Last Name:POWELL
Suffix:
Gender:F
Credentials:LCSW BCBA LBA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MICHELLE
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:2137 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2631
Mailing Address - Country:US
Mailing Address - Phone:917-436-6139
Mailing Address - Fax:718-299-7930
Practice Address - Street 1:2137 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2631
Practice Address - Country:US
Practice Address - Phone:917-436-6139
Practice Address - Fax:718-299-7930
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003760103K00000X
NY72086472104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker