Provider Demographics
NPI:1598049017
Name:COWAN, REBECCA M (PHD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:M
Last Name:COWAN
Suffix:
Gender:F
Credentials:PHD, LPC, NCC
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:GRACE
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC, NCC
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-397-6344
Mailing Address - Fax:757-606-1185
Practice Address - Street 1:600 CRAWFORD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-3820
Practice Address - Country:US
Practice Address - Phone:757-397-6344
Practice Address - Fax:757-606-1185
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005099101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1598049017OtherOPTIMA BEHAVIOAL HEALTH
VA1598049017OtherVIRGINIA PREMIER HEALTH PLAN
VA1598049017OtherCOVENTRY NATIONAL
VAPAROtherMULTIPLAN
VAPAROtherAETNA
VA1598049017Medicaid
VA448660OtherANTHEM BEHAVIORAL HEALTH
VAPAROtherUSA MANAGED CARE
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherCORVEL
VA-086OtherTRICARE/CHAMPUS
VA1598049017OtherCIGNA BEHAVIORAL HEALTH
VAPAROtherMAGELLAN HEALTH SERVICES
VA1598049017OtherUNITED BEHAVIORAL HEALTH
VAPAROtherMANAGED HEALTH NETWORK