Healthcare Provider Details

I. General information

NPI: 1609716943
Provider Name (Legal Business Name): MACAIAH V MCCOWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHEYENNE MOUNTAIN BLVD
COLORADO SPRINGS CO
80906-3700
US

IV. Provider business mailing address

10172 SEAWOLF DR
COLORADO SPRINGS CO
80925-8439
US

V. Phone/Fax

Practice location:
  • Phone: 719-493-8843
  • Fax:
Mailing address:
  • Phone: 254-661-4813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: