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NPI Code Detail

MEDICARE: KELSEY NICOLE MCCOWN

MEDICARE: KELSEY NICOLE MCCOWN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1538099676
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY NICOLE MCCOWN
Provider Business Mailing Address
First Line : 131 ELDEN ST
Second Line :
City : HERNDON
State : VA
Zip : 20170-4876
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3433 BRAMBLETON AVE STE 201A
Second Line :
City : ROANOKE
State : VA
Zip : 24018-6527
Country : US
Telephone Number : 804-562-9997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ KELSEY NICOLE MCCOWN ” Practice Location

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