Provider Demographics
NPI:1760852339
Name:COWHER, RUTH (LPC CRC CDAC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:COWHER
Suffix:
Gender:F
Credentials:LPC CRC CDAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-2221
Mailing Address - Country:US
Mailing Address - Phone:570-368-2624
Mailing Address - Fax:
Practice Address - Street 1:355 BROAD ST
Practice Address - Street 2:
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-2221
Practice Address - Country:US
Practice Address - Phone:570-368-2624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4654101YA0400X
PAPC 007329101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)