Provider Demographics
NPI:1245656453
Name:MCGOWN, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MCGOWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17904 GEORGIA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2277
Mailing Address - Country:US
Mailing Address - Phone:443-741-2489
Mailing Address - Fax:
Practice Address - Street 1:17904 GEORGIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-2277
Practice Address - Country:US
Practice Address - Phone:443-741-2489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional