Provider Demographics
NPI:1437105152
Name:BOWERS, MAXENE (LCSW)
Entity Type:Individual
Prefix:
First Name:MAXENE
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MAXENE
Other - Middle Name:
Other - Last Name:ARCIERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:800 PRESTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4420
Mailing Address - Country:US
Mailing Address - Phone:434-972-1800
Mailing Address - Fax:
Practice Address - Street 1:800 PRESTON AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4420
Practice Address - Country:US
Practice Address - Phone:434-972-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040036791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical