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Individual

MR. DOUGLAS ANDREW COWAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC, LADC

Contact information

Practice address
131 SPRING ST., PORTLAND, ME 04101
(207) 650-2632
(207) 767-0995
Mailing address
P.O. BOX 4693, PORTLAND, ME 04112
(207) 650-2632
(207) 767-0995

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC3002
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC3002
ME
101YM0800X
Mental Health Counselor
Primary
CC2708
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432729499
ME
Enumeration date
10/14/2009
Last updated
10/31/2013
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