Provider Demographics
NPI:1134302821
Name:MCGOWAN, MAUREEN (MAC, LPC,)
Entity Type:Individual
Prefix:MISS
First Name:MAUREEN
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:MAC, LPC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6744 CLAYTON RD STE 301
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1639
Mailing Address - Country:US
Mailing Address - Phone:314-640-4599
Mailing Address - Fax:
Practice Address - Street 1:6744 CLAYTON RD STE 301
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1639
Practice Address - Country:US
Practice Address - Phone:314-640-4599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014001557101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional