Breanna McGowan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P009491 Issued in NC

Practice address

4401 Providence LN Ste 121
Winston Salem, NC 27106-3226

Phone

(336) 896-1323

NPI assigned

Apr 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1881048924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 VILLAGE CREEK CIR APT H",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044799",
            "telephone_number": "980-439-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PROVIDENCE LN STE 121",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063226",
            "telephone_number": "336-896-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "10907",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P009491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Victoria Ellen McGhee, PHARMD
• Henderson Dwayne McGinnis, MD
• Samuel Wade McGinnis, LCMHC
• Elena McGinty, MSN, AOCNS, FNP-BC
• Christine Erin McGough, MD
• Megan Elizabeth Brock McGowan, M.D.
• Timothy Wade McGowen, M.D.
• Stacy McGrady, DPT
• Madelyn McGrath
• Michael Edward McGuire, LCSW, LMFT, LCAS

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.