Provider Demographics
NPI:1528595204
Name:COWLEY, CHARISSA (NCC)
Entity Type:Individual
Prefix:MS
First Name:CHARISSA
Middle Name:
Last Name:COWLEY
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 8TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1669
Mailing Address - Country:US
Mailing Address - Phone:202-832-7370
Mailing Address - Fax:
Practice Address - Street 1:2917 8TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1669
Practice Address - Country:US
Practice Address - Phone:202-832-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC685234101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor