Healthcare Provider Details

I. General information

NPI: 1578616900
Provider Name (Legal Business Name): CURTIS MCGOWN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 BALLARD ST
ALTAMONTE SPRINGS FL
32701-5441
US

IV. Provider business mailing address

3424 GERBER DAISY LN
OVIEDO FL
32766-6688
US

V. Phone/Fax

Practice location:
  • Phone: 407-339-7451
  • Fax:
Mailing address:
  • Phone: 407-227-9043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 7421
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: