Healthcare Provider Details

I. General information

NPI: 1811087992
Provider Name (Legal Business Name): DORIS ANN MCGOWAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 VAN AALST BLVD
FORT BENNING GA
31905-2102
US

IV. Provider business mailing address

PO BOX 1147
SMITHS STATION AL
36877-1147
US

V. Phone/Fax

Practice location:
  • Phone: 762-408-4069
  • Fax:
Mailing address:
  • Phone: 706-587-3432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW003645
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1966C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: