Provider Demographics
NPI:1295016855
Name:BOWER, STEVEN TIMOTHY (MSW, LCSW, LCAS, CCS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:TIMOTHY
Last Name:BOWER
Suffix:
Gender:M
Credentials:MSW, LCSW, LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BREWSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-2538
Mailing Address - Country:US
Mailing Address - Phone:910-619-3349
Mailing Address - Fax:
Practice Address - Street 1:25 WESTRIDGE MARKET PL
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9174
Practice Address - Country:US
Practice Address - Phone:828-418-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1895101YA0400X
NCC007425104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007993Medicaid
NC6007993Medicaid