Provider Demographics
NPI:1902225360
Name:COWART, STEPHEN BRENT (LMHC-LP, MA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BRENT
Last Name:COWART
Suffix:
Gender:M
Credentials:LMHC-LP, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 EASTON STATION RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-5947
Mailing Address - Country:US
Mailing Address - Phone:917-972-5626
Mailing Address - Fax:
Practice Address - Street 1:245 EASTON STATION RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-5947
Practice Address - Country:US
Practice Address - Phone:917-972-5626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYAPPLIED FOR101YM0800X
NY007716-00101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health