Provider Demographics
NPI:1730111915
Name:MCCOWN, JULIA E (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:E
Last Name:MCCOWN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 SPRING VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704-9587
Mailing Address - Country:US
Mailing Address - Phone:203-429-6741
Mailing Address - Fax:304-926-6001
Practice Address - Street 1:104 ALEX LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2952
Practice Address - Country:US
Practice Address - Phone:203-926-6001
Practice Address - Fax:304-926-8692
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP008167761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVDP00816776OtherLICSW