Mark J Macgowan, PHD LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW3871 Issued in FL

Practice address

14401 Old Cutler Rd
Palmetto Bay, FL 33158-1722

Phone

(786) 573-7010

NPI assigned

Oct 2, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellspring Counseling, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Palmetto Bay, FL
  • NPI 1558686543
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1003391327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14401 OLD CUTLER RD",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331581722",
            "telephone_number": "786-573-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14401 OLD CUTLER RD",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331581722",
            "telephone_number": "786-573-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACGOWAN",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramon Enrique Lugo, HOUSE PHYSICIAN
• Luminous Mental Health LLC
• Luz Y Fe Behavior Services Corp
• Lyf Aesthetics
• Jasmine Mabjeesh, DDS
• Mel Macias Mestre
• Maria Gabriella Madriz, LCSW
• Magnolia Sleep Center and Wellness, LLC
• Main Street Children'S Dentistry & Orthodontics of Palmetto Bay, PA
• Caitlin Jeanette Maitre, OT/L

• Clinical Social Worker in Palmetto Bay, FL
• Providers in Palmetto Bay, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.