Provider Demographics
NPI:1184973646
Name:MCGOWN, JENNA (MS, LCMHC)
Entity type:Individual
Prefix:MS
First Name:JENNA
Middle Name:
Last Name:MCGOWN
Suffix:
Gender:F
Credentials:MS, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 BATTLEGROUND AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-2636
Mailing Address - Country:US
Mailing Address - Phone:336-604-4694
Mailing Address - Fax:
Practice Address - Street 1:3225 BATTLEGROUND AVE STE 6
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2636
Practice Address - Country:US
Practice Address - Phone:336-604-4694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9520101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health