1598049017 NPI number — DR. REBECCA M. COWAN PHD, LPC, NCC

Table of content: DR. REBECCA M. COWAN PHD, LPC, NCC (NPI 1598049017)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598049017 NPI number — DR. REBECCA M. COWAN PHD, LPC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COWAN
Provider First Name:
REBECCA
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, LPC, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCBRIDE
Provider Other First Name:
REBECCA
Provider Other Middle Name:
GRACE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD, LPC, NCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598049017
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 936
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23501-0936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-397-6344
Provider Business Mailing Address Fax Number:
757-606-1185

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 CRAWFORD ST
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23704-3820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-397-6344
Provider Business Practice Location Address Fax Number:
757-606-1185
Provider Enumeration Date:
10/03/2011

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: 101YP2500X , with the licence number:  0701005099 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1598049017 . This is a "OPTIMA BEHAVIOAL HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1598049017 . This is a "VIRGINIA PREMIER HEALTH PLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1598049017 . This is a "COVENTRY NATIONAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "MULTIPLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1598049017 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 448660 . This is a "ANTHEM BEHAVIORAL HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "USA MANAGED CARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "VIRGINIA HEALTH NETWORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "CORVEL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: -086 . This is a "TRICARE/CHAMPUS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1598049017 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "MAGELLAN HEALTH SERVICES" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1598049017 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "MANAGED HEALTH NETWORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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