Provider Demographics
NPI:1376161299
Name:BOWMAN, JULIE EMBREY (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:EMBREY
Last Name:BOWMAN
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 1:7600 ELLIS CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20111-8006
Mailing Address - Country:US
Mailing Address - Phone:703-628-5788
Mailing Address - Fax:
Practice Address - Street 1:3929 OLD LEE HWY STE 92D
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2421
Practice Address - Country:US
Practice Address - Phone:571-250-7844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904007435101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health