Provider Demographics
NPI:1508198060
Name:COWAN-GASCOIGNE, CHRISTINE (LISW-S)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:COWAN-GASCOIGNE
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:GASCOIGNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW-S
Mailing Address - Street 1:11905 SANDGATE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2319
Mailing Address - Country:US
Mailing Address - Phone:440-729-1550
Mailing Address - Fax:440-729-0948
Practice Address - Street 1:29525 CHAGRIN BLVD.
Practice Address - Street 2:310
Practice Address - City:PEPPER PIKE
Practice Address - State:OH
Practice Address - Zip Code:44124
Practice Address - Country:US
Practice Address - Phone:216-292-2020
Practice Address - Fax:216-292-2020
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.08000471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical