Provider Demographics
NPI:1275257909
Name:CLEMENT BOWLES, COURTNEY ELIZABETH (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:CLEMENT BOWLES
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:CLEMENT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMHC-A
Mailing Address - Street 1:3133 WRIGHTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4111
Mailing Address - Country:US
Mailing Address - Phone:910-742-0489
Mailing Address - Fax:910-742-3979
Practice Address - Street 1:3133 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4111
Practice Address - Country:US
Practice Address - Phone:910-742-0489
Practice Address - Fax:910-742-3979
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18403101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health