Provider Demographics
NPI:1457768418
Name:COWMAN, ELLEN GRACE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:GRACE
Last Name:COWMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:VAN BOCKERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:715 HORIZON DR
Mailing Address - Street 2:STE 225
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:244 EAST AGATE AVE
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CO
Practice Address - Zip Code:80446
Practice Address - Country:US
Practice Address - Phone:970-887-2179
Practice Address - Fax:970-887-9311
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099240581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical