Jessica Lyn Cowan, LCSW
Individual provider Active NPI Professional Counselor · Hurricane, UT
NPI 1134466683 · NPPES record last updated Nov 30, 2022
Key facts
- NPI
- 1134466683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 11079157 (UT)
- Practice address
- 802 W 100 S
Hurricane, UT 84737-3229 - Phone
- (435) 319-0889
- NPI assigned
- Jan 3, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mend Counseling Center LLC
Practice addresses (Care Compare)
55 N 200
Suite 2
St George, UT 84770-1303
Phone (435) 301-8969
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240208000889 | UT | Practitioner - Clinical Social Worker | 0244673085 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11079157-3502 | UT | MD | Counselor |
| 11079157 | UT | MD | Professional Counselor |
| 165617091 | UT | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M.E.N.D. Counseling Center, L.L.C. | Current |
Accepting new patients |
Locations
55 N 200 W
Ste 2
St George, UT 84770
Phone (435) 301-8969
491 E Riverside Dr
Ste 1B
St George, UT 84790
Phone (435) 301-8969
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 165617091 | UT | |
| Professional Counselor | 101YP2500X | 11079157 | UT | Yes |
| Counselor | 101Y00000X | 11079157-3502 | UT |
Addresses
Primary practice location
802 W 100 S
Hurricane, UT 84737-3229
Mailing address
802 W 100 S
Hurricane, UT 84737-3229
Phone (801) 759-8558
Other providers in Hurricane, UT
- City of Hurricane
- Nicole Cook
- Coral Canyon Joint & Spine Health
- Core Compass Counseling Inc
- Scott Corsi
- Reena Price Curl
- Amanda Jeanne Horrocks Cushing
- Jessica Ann Dalley
- Kristian Dalley
- Jason Davey
All providers in Hurricane, UT · Professional Counselor in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.