WILLIETTE POWELL (LICDC) – Peer Specialist, NPI 1043758907

WILLIETTE POWELL (LICDC) is a healthcare provider. based in Cleveland, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LICDC. They hold a License No. 161339 (OH). The NPI Number for WILLIETTE POWELL (LICDC) is 1043758907

Main info

Female
Sole Proprietor
10 Years Of Experience
Name
WILLIETTE POWELL (LICDC)
NPI
1043758907
Phone
(216) 283-4400
Address
18400 E PARK DR
Enumeration Date
10 February 2017
Last Update Date
8 October 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2016 (10 years ago)
PAC ID
2668999764
Professional Enrollment ID
I20250512001229
Address ID
OH441214038SO1496XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:9State licenses:2Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

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Provider Addresses for WILLIETTE POWELL (LICDC)

  • 18400, East Park Drive, Cleveland, Cuyahoga County, Ohio, 44119, United States

    CLEVELAND, OH 441192057

    Phone: (216) 283-4400

    Fax: (216) 283-5359

    Type: Mailing

  • Murtis Taylor Human Services System, 13422, Kinsman Road, Mount Pleasant, Cleveland, Cuyahoga County, Ohio, 44120, United States

    CLEVELAND, OH 441204410

    Phone: (216) 283-4400

    Fax: (216) 283-5359

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250512001229IMental Health CounselorOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44119)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for WILLIETTE POWELL (LICDC)?
WILLIETTE POWELL (LICDC) — NPI 1043758907 — is the standard way to identify this listing.
Can I rely on WILLIETTE POWELL (LICDC) being an active provider?
As of the registry snapshot, WILLIETTE POWELL (LICDC) is marked active.
What is WILLIETTE POWELL (LICDC)'s primary classification?
Peer Specialist is the headline specialty for WILLIETTE POWELL (LICDC) here. Clinical services aligned with this taxonomy classification.
What area does WILLIETTE POWELL (LICDC) serve?
WILLIETTE POWELL (LICDC)'s listing highlights Cleveland, Ohio; more addresses can appear in NPPES.
Is the information about WILLIETTE POWELL (LICDC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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