Provider Demographics
NPI:1598470213
Name:SUZY COWEN , LICENSED CLINICAL SOCIAL WORKER, P.C.
Entity Type:Organization
Organization Name:SUZY COWEN , LICENSED CLINICAL SOCIAL WORKER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUZY
Authorized Official - Middle Name:
Authorized Official - Last Name:COWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-919-9380
Mailing Address - Street 1:PO BOX 644
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-0644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3855 VIA NONA MARIE STE 202A
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8642
Practice Address - Country:US
Practice Address - Phone:831-402-5756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center