Provider Demographics
NPI:1265833784
Name:COWAN, TAYLOR BOYD (MA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:BOYD
Last Name:COWAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PLEASANT ST NW
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4447
Mailing Address - Country:US
Mailing Address - Phone:703-935-0058
Mailing Address - Fax:
Practice Address - Street 1:228 S WASHINGTON ST STE 310
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5404
Practice Address - Country:US
Practice Address - Phone:917-841-5184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60469022163W00000X
WAAP60670972363LP0808X
WAMC60296135101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No101Y00000XBehavioral Health & Social Service ProvidersCounselor