Provider Demographics
NPI:1861633075
Name:MOWRER, JEFFREY (LPC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MOWRER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 EAST 6TH STREET
Mailing Address - Street 2:BOX 879
Mailing Address - City:MCLAUGHLIN
Mailing Address - State:SD
Mailing Address - Zip Code:57642
Mailing Address - Country:US
Mailing Address - Phone:605-823-4458
Mailing Address - Fax:605-823-2017
Practice Address - Street 1:701 EAST 6TH STREET
Practice Address - Street 2:BOX 879
Practice Address - City:MCLAUGHLIN
Practice Address - State:SD
Practice Address - Zip Code:57642
Practice Address - Country:US
Practice Address - Phone:605-823-4458
Practice Address - Fax:605-823-2017
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional