MEDICARE: JAMES C COWSER LCSW, MCAP

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CADC 0777	KY
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CCDP-D 6084	PA
3	1041C0700X	Clinical Social Worker	LCSW 2035	KY

General Provider Information

NPI Number	:	1447387816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES C COWSER LCSW, MCAP

Provider Business Mailing Address
First Line	:	1430 WILKINS CIR
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-1336
Country	:	US
Telephone Number	:	307-776-0238
Fax Number	:	307-265-7277

Provider Business Practice Location Address
First Line	:	1430 WILKINS CIR
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-1336
Country	:	US
Telephone Number	:	307-776-0238
Fax Number	:	307-265-7277

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	11/08/2023

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