Provider Demographics
NPI:1225637838
Name:MCGOWAN, SUMMER LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:LYNN
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:LYNN
Other - Last Name:SWINDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:12040 SOUTHERN BREEZE
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MO
Mailing Address - Zip Code:63841-2890
Mailing Address - Country:US
Mailing Address - Phone:573-820-0703
Mailing Address - Fax:
Practice Address - Street 1:12040 SOUTHERN BREEZE
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MO
Practice Address - Zip Code:63841-2890
Practice Address - Country:US
Practice Address - Phone:573-820-0703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020032040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional