Provider Demographics
NPI:1619008372
Name:MCGOWAN, SHIRLEY FAY (LPC)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:FAY
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:MCGOWAN
Other - Last Name:REA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:650 JOEL DR
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5318
Mailing Address - Country:US
Mailing Address - Phone:270-798-4097
Mailing Address - Fax:270-798-2954
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-798-4097
Practice Address - Fax:270-798-2954
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000093101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional