Provider Demographics
NPI:1295894996
Name:COWETT, SANDRA LARGEN (LCSWC ACSW QCSW)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LARGEN
Last Name:COWETT
Suffix:
Gender:F
Credentials:LCSWC ACSW QCSW
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:LARGEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3919 TILA ROAD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1323
Mailing Address - Country:US
Mailing Address - Phone:410-529-1386
Mailing Address - Fax:410-771-9208
Practice Address - Street 1:9 SCHILLING RD
Practice Address - Street 2:STE 200 SANDRA L COWETT LCSW C
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-8601
Practice Address - Country:US
Practice Address - Phone:410-527-0280
Practice Address - Fax:410-771-9208
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD045611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
9917Medicare ID - Type Unspecified