Provider Demographics
NPI:1376805531
Name:BOWKER, ALISHA KATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:KATHERINE
Last Name:BOWKER
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 1:1021 ELLISON AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1903
Mailing Address - Country:US
Mailing Address - Phone:818-632-9703
Mailing Address - Fax:
Practice Address - Street 1:6500 GLENRIDGE PARK PL STE 8
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3450
Practice Address - Country:US
Practice Address - Phone:502-309-4699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085031-11041C0700X
NY0840881041C0700X
KY2535241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical