Provider Demographics
NPI:1225344245
Name:COWAN, LORI ANNE (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANNE
Last Name:COWAN
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:ANNE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LMFT
Mailing Address - Street 1:P. O. BOX 287
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-739-0350
Mailing Address - Fax:804-639-5492
Practice Address - Street 1:9120 BEAVER BRIDGE RD
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-1497
Practice Address - Country:US
Practice Address - Phone:804-739-0350
Practice Address - Fax:804-639-5492
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002396101YP2500X
VA0717000485106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist