Provider Demographics
NPI:1033634761
Name:COWART, CHIVON TANARA (MSW)
Entity Type:Individual
Prefix:MISS
First Name:CHIVON
Middle Name:TANARA
Last Name:COWART
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:CHIVON
Other - Middle Name:TANARA
Other - Last Name:COWART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2936 DREW ST APT 1314
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3056
Mailing Address - Country:US
Mailing Address - Phone:727-483-2283
Mailing Address - Fax:
Practice Address - Street 1:2936 DREW ST APT 1314
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-3056
Practice Address - Country:US
Practice Address - Phone:727-483-2283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical