Provider Demographics
NPI:1477785426
Name:BOWMAN, SHENELLE ELIZABETH (LPC-I)
Entity Type:Individual
Prefix:MS
First Name:SHENELLE
Middle Name:ELIZABETH
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 CATAWBA CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5253
Mailing Address - Country:US
Mailing Address - Phone:803-530-3199
Mailing Address - Fax:
Practice Address - Street 1:814 CATAWBA CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-5253
Practice Address - Country:US
Practice Address - Phone:803-530-3199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health