Provider Demographics
NPI:1942791496
Name:POWELL, ANDREW JOEL (LIMHP, LCSW, PLADC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOEL
Last Name:POWELL
Suffix:
Gender:M
Credentials:LIMHP, LCSW, PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 DODGE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3251
Mailing Address - Country:US
Mailing Address - Phone:402-553-6000
Mailing Address - Fax:402-553-2428
Practice Address - Street 1:4545 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3251
Practice Address - Country:US
Practice Address - Phone:402-553-6000
Practice Address - Fax:402-553-2428
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11479101YM0800X
NE72461041C0700X
NE2333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical