MEDICARE: CLARENCE VINCENT COWLEY RPRS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0735000965	VA

General Provider Information

NPI Number	:	1588519847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARENCE VINCENT COWLEY RPRS

Provider Business Mailing Address
First Line	:	3794 TOWNE POINT RD APT E
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703-2562
Country	:	US
Telephone Number	:	757-298-4145
Fax Number	:

Provider Business Practice Location Address
First Line	:	3794 TOWNE POINT RD APT E
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703-2562
Country	:	US
Telephone Number	:	757-298-4145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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