Provider Demographics
NPI:1023094067
Name:SOWDER, KATHY (LPCC, CCDC, III E)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:
Last Name:SOWDER
Suffix:
Gender:F
Credentials:LPCC, CCDC, III E
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7086 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4224
Mailing Address - Country:US
Mailing Address - Phone:937-435-5200
Mailing Address - Fax:937-435-5200
Practice Address - Street 1:7086 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4224
Practice Address - Country:US
Practice Address - Phone:937-435-5200
Practice Address - Fax:937-435-5200
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0000363101YA0400X, 101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH05592700OtherMAGELLAN HEALTH SRVCS
OH0000073621OtherMANAGED HEALTH NETWORK
OH000000016169OtherANTHEM
OH180942OtherVALUE OPTIONS
OH7379058OtherAETNA