1295894996 NPI number — MRS. SANDRA LARGEN COWETT LCSWC ACSW QCSW

Table of content: MRS. SANDRA LARGEN COWETT LCSWC ACSW QCSW (NPI 1295894996)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295894996 NPI number — MRS. SANDRA LARGEN COWETT LCSWC ACSW QCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COWETT
Provider First Name:
SANDRA
Provider Middle Name:
LARGEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSWC ACSW QCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LARGEN
Provider Other First Name:
SANDRA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1295894996
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3919 TILA ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21234-1323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-529-1386
Provider Business Mailing Address Fax Number:
410-771-9208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 SCHILLING RD
Provider Second Line Business Practice Location Address:
STE 200 SANDRA L COWETT LCSW C
Provider Business Practice Location Address City Name:
HUNT VALLEY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21031-8601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-527-0280
Provider Business Practice Location Address Fax Number:
410-771-9208
Provider Enumeration Date:
12/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  04561 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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