Healthcare Provider Details

I. General information

NPI: 1457613127
Provider Name (Legal Business Name): ELIZABETH FAYE MCDOWELL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 S 18TH AVE
STURGEON BAY WI
54235-1401
US

IV. Provider business mailing address

1745 ALFRED DR
LUXEMBURG WI
54217-1364
US

V. Phone/Fax

Practice location:
  • Phone: 920-746-0510
  • Fax:
Mailing address:
  • Phone: 231-429-1226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101006668
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: