Provider Demographics
NPI:1376155903
Name:MCGOWAN, CELIA MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CELIA
Middle Name:MARIE
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2787 S GRAFHILL DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-2363
Mailing Address - Country:US
Mailing Address - Phone:251-404-7362
Mailing Address - Fax:251-404-7362
Practice Address - Street 1:2787 S GRAFHILL DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-2363
Practice Address - Country:US
Practice Address - Phone:251-404-7362
Practice Address - Fax:251-404-7362
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4223C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty