Provider Demographics
NPI:1013254689
Name:MCGOWAN, LASHANDA (LCSW, MED)
Entity type:Individual
Prefix:
First Name:LASHANDA
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:LCSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3969
Mailing Address - Country:US
Mailing Address - Phone:907-600-9285
Mailing Address - Fax:
Practice Address - Street 1:2220 N STAR ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-1884
Practice Address - Country:US
Practice Address - Phone:907-600-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL164171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500812880Medicaid
AKMH3237Medicaid