Provider Demographics
NPI:1295818946
Name:BOWDEN, LAURA JEAN (LMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 ACUSHNET AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745
Mailing Address - Country:US
Mailing Address - Phone:508-291-6925
Mailing Address - Fax:508-295-4375
Practice Address - Street 1:215 SANDWICH ROAD
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571
Practice Address - Country:US
Practice Address - Phone:508-291-6925
Practice Address - Fax:508-295-4375
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5445101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health