Healthcare Provider Details

I. General information

NPI: 1447638093
Provider Name (Legal Business Name): HEATHER SOWERS LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11350 MCCORMICK RD STE 800
HUNT VALLEY MD
21031-1002
US

IV. Provider business mailing address

PO BOX 75
STEWARTSTOWN PA
17363-0075
US

V. Phone/Fax

Practice location:
  • Phone: 410-800-2169
  • Fax:
Mailing address:
  • Phone: 484-288-0379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23114
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: