Provider Demographics
NPI:1043568785
Name:GOWDY, VENITA ELIZABETH (LPC, RPT)
Entity type:Individual
Prefix:MRS
First Name:VENITA
Middle Name:ELIZABETH
Last Name:GOWDY
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 13TH CT NW
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:AL
Mailing Address - Zip Code:35215-6004
Mailing Address - Country:US
Mailing Address - Phone:205-480-7779
Mailing Address - Fax:
Practice Address - Street 1:940 MONTCLAIR RD
Practice Address - Street 2:STE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1217
Practice Address - Country:US
Practice Address - Phone:205-480-7779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health