Healthcare Provider Details

I. General information

NPI: 1316097488
Provider Name (Legal Business Name): JAMES ARTHUR COWLEY SR. MSW CSW SAP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17352 W 12 MILE RD BURDETTE & DOSS CLINIC
SOUTHFIELD MI
48076
US

IV. Provider business mailing address

29143 EVERGREEN RD #16
SOUTHFIELD MI
48076
US

V. Phone/Fax

Practice location:
  • Phone: 248-559-0730
  • Fax: 248-569-7626
Mailing address:
  • Phone: 248-842-8223
  • Fax: 248-569-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801014330
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: