Healthcare Provider Details

I. General information

NPI: 1629766381
Provider Name (Legal Business Name): CORASON LEE KOWALSKI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 BIRCHCREEK DR
WESLEY CHAPEL FL
33544-7371
US

IV. Provider business mailing address

2917 BIRCHCREEK DR
WESLEY CHAPEL FL
33544-7371
US

V. Phone/Fax

Practice location:
  • Phone: 813-807-1086
  • Fax:
Mailing address:
  • Phone: 813-807-1086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW26927
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: