Provider Demographics
NPI:1376713396
Name:COWIE, KATHLEEN E
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:COWIE
Suffix:
Gender:F
Credentials:
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 323
Mailing Address - Street 2:
Mailing Address - City:BRANT ROCK
Mailing Address - State:MA
Mailing Address - Zip Code:02020-0323
Mailing Address - Country:US
Mailing Address - Phone:781-704-4915
Mailing Address - Fax:508-433-1871
Practice Address - Street 1:439 COLUMBIA RD STE 205
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2393
Practice Address - Country:US
Practice Address - Phone:781-704-4915
Practice Address - Fax:508-433-1871
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10207671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N/AOtherBEACON HEALTH STRATEGIES
N/AOtherBEACON HEALTH STRATEGIES