Provider Demographics
NPI:1083647150
Name:BOWLES, CHERYL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:BOWLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3095 SNOWBERRY ST.
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:NV
Mailing Address - Zip Code:89429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3595 HWY. 50 WEST
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:NV
Practice Address - Zip Code:89429-1136
Practice Address - Country:US
Practice Address - Phone:775-577-0319
Practice Address - Fax:775-577-9571
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5117-N101YM0800X
MSC54781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSR14863Medicare UPIN