Provider Demographics
NPI:1598761173
Name:ROWAN, NOELL L (LCSW)
Entity Type:Individual
Prefix:
First Name:NOELL
Middle Name:L
Last Name:ROWAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVLLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3554
Mailing Address - Country:US
Mailing Address - Phone:812-282-1888
Mailing Address - Fax:812-285-8392
Practice Address - Street 1:510 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVLLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3554
Practice Address - Country:US
Practice Address - Phone:812-282-1888
Practice Address - Fax:812-285-8392
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002976A104100000X
KY1026104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2773554000OtherPASSPORT ADVANTAGE
KY78903689Medicaid
209754000OtherMAGELLAN
50704000OtherMAGELLAN GROUP
IN800012454OtherMEDICARE RAILROAD
KY65927857OtherMEDICAID GROUP MD
000000194075OtherANTHEM
KY2444451000OtherPASSPORT GROUP
KY8200059700Medicaid
IN100386460OtherMEDICAID GROUP
KYCK2274OtherRAILROAD MEDICARE GROUP
000000056294OtherANTHEM GROUP
IN200108550AMedicaid
INCG3623OtherRAILROAD MEDICARE GROUP
KYP00416177OtherMEDICARE RAILROAD
INCG3623OtherRAILROAD MEDICARE GROUP
KY65927857OtherMEDICAID GROUP MD
IN160860IMedicare ID - Type Unspecified
KY0676411Medicare ID - Type Unspecified