Provider Demographics
NPI:1629307053
Name:MCDOWELL, MARC RICHARD (MSW/LCSW)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:RICHARD
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7544 DEER PATH LN
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34637-7573
Mailing Address - Country:US
Mailing Address - Phone:813-380-1322
Mailing Address - Fax:
Practice Address - Street 1:8905 REGENTS PARK DR
Practice Address - Street 2:SUITE 230
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3081
Practice Address - Country:US
Practice Address - Phone:813-380-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 78041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical