Provider Demographics
NPI:1609681865
Name:POWELL, DANICA JAVON (CPD)
Entity type:Individual
Prefix:
First Name:DANICA
Middle Name:JAVON
Last Name:POWELL
Suffix:
Gender:F
Credentials:CPD
Other - Prefix:
Other - First Name:DANICA
Other - Middle Name:JAVON
Other - Last Name:PICKENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPD
Mailing Address - Street 1:8 E 109TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3402
Mailing Address - Country:US
Mailing Address - Phone:661-457-0480
Mailing Address - Fax:
Practice Address - Street 1:8 E 109TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3402
Practice Address - Country:US
Practice Address - Phone:661-457-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula