| Doctor Name: | MR. KENNETH WAYNE MCCOWN |
| NPI Number: | 1538143458 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC, NCC, MAC |
| License Number: | 1432 |
| Business Practice Address: | 9501 Farrell Rd Fort Belvoir, VA - 220605901 |
| Business Phone Number: | 7038050948 |
| Business Fax Number: | 7038059025 |
| Mailing Address: | 6806 Wemberly Way, MC LEAN |
| State: | VA |
| Postal Code: | 221011531 |
| Phone Number: | 7033568266 |
| Fax Number: | 7038050788 |
| NPI Enumeration Date: | 12/05/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | 1432 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |