Individual
GARRETT MCKOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1310 W MAIN ST STE 100, RUSSELLVILLE, AR 72801-2803
(479) 964-2011
Mailing address
P.O. DRAWER 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
11188-M
AR
1041C0700X
Clinical Social Worker
Primary
11188-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270595795
—
AR
Enumeration date
07/26/2021
Last updated
03/14/2024
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