Provider Demographics
NPI:1992343727
Name:COWHICK, JAIME (MAMHC, CAC, CBHCM)
Entity type:Individual
Prefix:MS
First Name:JAIME
Middle Name:
Last Name:COWHICK
Suffix:
Gender:F
Credentials:MAMHC, CAC, CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 LIBERTY ST APT 11
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-2433
Mailing Address - Country:US
Mailing Address - Phone:754-214-2729
Mailing Address - Fax:
Practice Address - Street 1:1845 LIBERTY ST APT 11
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-2433
Practice Address - Country:US
Practice Address - Phone:754-214-2729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000OtherHAVE NOT OBTAINED