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General NPI Number Information
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NPI Number | 1336685981
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Entity Type | Organization
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Legal Business Name | JAYME E COWAN LLC
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 4316 S 48TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-1287
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Country | US
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Telephone | 402-890-7713
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Fax |
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Provider Business Mailing Address
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Address Line | 4316 S 48TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-1287
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Country | US
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Telephone | 402-890-7713
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JAYME ELIZABETH COWAN
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Credential | PLMHP LDAC
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Telephone | 402-890-7713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1084
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9792
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License Number State | NE
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