Individual provider Active NPI

Shahidrah R. Cowgill, M.A., LPC-S, NCC

  • Professional Counselor
  • Little Elm, TX
National Provider Identifier
1205134608
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
64254 Issued in TX
Practice address
2601 Little Elm Pkwy Ste 302
Little Elm, TX 75068-1919
Phone
(214) 475-0345
Fax
(214) 935-3302
NPI assigned
Mar 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 64254 TX Primary

Addresses

Primary practice location

2601 Little Elm Pkwy Ste 302
Little Elm, TX 75068-1919

Mailing address

2601 Little Elm Pkwy Ste 302
Little Elm, TX 75068-1919
Phone (214) 475-0345

Other practice location 1

550 S Watters Rd Ste 219
Allen, TX 75013-5228
Phone (214) 475-0345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
64254TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamental Foundations Counseling Center, PLLC Professional CurrentSince Aug 8, 2021 Accepting new patients
Fundamental Foundations Counseling Center, PLLC Past Accepting new patients

Locations

550 S Watters Rd
Ste 219
Allen, TX 75013
Phone (214) 475-0345

2601 Little Elm Pkwy
Ste 302
Little Elm, TX 75068
Phone (214) 475-0345

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1205134608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 LITTLE ELM PKWY STE 302",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750681919",
            "telephone_number": "214-475-0345",
            "fax_number": "214-935-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 LITTLE ELM PKWY STE 302",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750681919",
            "telephone_number": "214-475-0345",
            "fax_number": "214-935-3302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Watters Rd Ste 219",
            "address_purpose": "LOCATION",
            "city": "Allen",
            "state": "TX",
            "postal_code": "750135228",
            "country_code": "US",
            "telephone_number": "214-475-0345",
            "fax_number": "214-935-3302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COWGILL",
        "first_name": "SHAHIDRAH",
        "middle_name": "R.",
        "credential": "M.A., LPC-S, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2021-08-05",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "64254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Elm, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.