Provider Demographics
NPI:1942700075
Name:GOWANS, CASEY (MSW, CBHCMS)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:GOWANS
Suffix:
Gender:F
Credentials:MSW, CBHCMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 W BROWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-1018
Mailing Address - Country:US
Mailing Address - Phone:954-587-1008
Mailing Address - Fax:954-587-0080
Practice Address - Street 1:8358 W OAKLAND PARK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7340
Practice Address - Country:US
Practice Address - Phone:954-792-9241
Practice Address - Fax:954-587-0080
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FLSW207281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical