Provider Demographics
NPI:1285798801
Name:COWAN, JEFFREY E (LMLP)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:E
Last Name:COWAN
Suffix:
Gender:M
Credentials:LMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 LAMAR AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3299
Mailing Address - Country:US
Mailing Address - Phone:913-826-4200
Mailing Address - Fax:
Practice Address - Street 1:6440 NIEMAN RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-3326
Practice Address - Country:US
Practice Address - Phone:913-826-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1008101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional