Provider Demographics
NPI:1306393533
Name:GOWING, JEFFREY DONALD (LPC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DONALD
Last Name:GOWING
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5027
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-0027
Mailing Address - Country:US
Mailing Address - Phone:708-955-5466
Mailing Address - Fax:
Practice Address - Street 1:1576 PECK ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-2547
Practice Address - Country:US
Practice Address - Phone:231-220-9288
Practice Address - Fax:231-241-1131
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017563101YP2500X, 101YM0800X
MI6401015547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional