Provider Demographics
NPI:1386470508
Name:MCGOWAN, MAURA TIERNAN (MED, LPCC)
Entity type:Individual
Prefix:MS
First Name:MAURA
Middle Name:TIERNAN
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1373 N FRANKLIN ST APT G
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2425
Mailing Address - Country:US
Mailing Address - Phone:484-800-6748
Mailing Address - Fax:
Practice Address - Street 1:1325 S COLORADO BLVD # B108
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3303
Practice Address - Country:US
Practice Address - Phone:303-909-9054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021314101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional