| Benny Lee Powell, MDIV, LCAC | |
|
2100 Goshen Rd, Fort Wayne, IN 46808-1493 | |
| (240) 471-3500 | |
| (260) 471-4263 |
| Full Name | Benny Lee Powell |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2100 Goshen Rd, Fort Wayne, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215163316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 87000082A (Indiana) | Primary |
| Entity Name | The Otis R Bowen Center For Human Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639172810 PECOS PAC ID: 7618950965 Enrollment ID: O20050404000853 |
| Mailing Address | Practice Location Address |
|---|---|
| Benny Lee Powell, MDIV, LCAC 850 N Harrison St, Attn: Anne Lawson - Credentialing, Warsaw, IN 46580-3163 Ph: (574) 267-7169 | Benny Lee Powell, MDIV, LCAC 2100 Goshen Rd, Fort Wayne, IN 46808-1493 Ph: (240) 471-3500 |
Courtney Lesley Washington, Counselor Medicare: Accepting Medicare Assignments Practice Location: 909 E State Blvd, Fort Wayne, IN 46805 Phone: 260-481-2700 | |
Alicia Jean Digiulio, MA, MSED, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9417 Saint Joe Center Rd, Fort Wayne, IN 46835 Phone: 260-255-5289 | |
Jennifer Perry, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 909 E State Blvd, Fort Wayne, IN 46805 Phone: 260-481-2700 Fax: 260-481-2709 | |
Raphilla D Dixie, Counselor Medicare: Medicare Enrolled Practice Location: 3005 E State Blvd, Fort Wayne, IN 46805 Phone: 260-267-9498 Fax: 260-739-3618 | |
Timothy Jay Hill, MSED Counselor Medicare: Not Enrolled in Medicare Practice Location: 2100 Goshen Rd, Fort Wayne, IN 46808 Phone: 260-471-3500 | |
Rita Kay Self, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3010 E State Blvd, Fort Wayne, IN 46805 Phone: 260-471-2300 Fax: 260-471-2778 | |
Rachida Bejja, MSED, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10828 Coldwater Rd, Fort Wayne, IN 46845 Phone: 260-415-8267 Fax: 260-426-0270 |