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NPI Code Detail

MEDICARE: KENEYSHA COWDEN LCSW

MEDICARE:   KENEYSHA  COWDEN  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 Worker252506KY
21041C0700XClinical Social WorkerCSW006818GA
3106H00000XMarriage & Family Therapist204881TX
4106H00000XMarriage & Family TherapistMFT001700GA
51041C0700XClinical Social Worker105636TX

General Provider Information

NPI Number : 1922369073
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENEYSHA COWDEN LCSW
Provider Business Mailing Address
First Line : 2204 JUAREZ DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76177-1200
Country : US
Telephone Number : 270-319-2819
Fax Number : 817-880-7117
Provider Business Practice Location Address
First Line : 2204 JUAREZ DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76177-1200
Country : US
Telephone Number : 270-319-2819
Fax Number : 817-880-7117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2012
Last Update Date : 05/02/2023

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Directions to “ KENEYSHA COWDEN LCSW” Practice Location

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