Provider Demographics
NPI:1497107593
Name:MCGOWAN, KENLO ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KENLO
Middle Name:ANN
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:C/O STEPPING STONES MMC
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:814-333-5813
Mailing Address - Fax:814-333-5817
Practice Address - Street 1:1034 GROVE ST
Practice Address - Street 2:C/O STEPPING STONES MMC
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2945
Practice Address - Country:US
Practice Address - Phone:814-333-5813
Practice Address - Fax:814-333-5817
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008933101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional