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NPI Code Detail

MEDICARE: DOROTHY BENSON MCGOWN LCSW

MEDICARE: DOROTHY BENSON MCGOWN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSW4462FL

General Provider Information

NPI Number : 1225021744
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY BENSON MCGOWN LCSW
Provider Business Mailing Address
First Line : 4161 CARMICHAEL AVE
Second Line : BLDG 3300, SUITE 150
City : JACKSONVILLE
State : FL
Zip : 32207-2353
Country : US
Telephone Number : 904-396-8750
Fax Number : 904-396-8759
Provider Business Practice Location Address
First Line : 1601 S.W. ARCHER ROAD
Second Line : MALCOM RANDALL VA MEDICAL CENTER
City : GAINESVILLE
State : FL
Zip : 32608-1197
Country : US
Telephone Number : 352-376-1611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 03/24/2017

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