Provider Demographics
NPI:1508033895
Name:BOWMAN, CHERISH LUCILLE
Entity Type:Individual
Prefix:MRS
First Name:CHERISH
Middle Name:LUCILLE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHERISH
Other - Middle Name:LUCILLE
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2484 MAPLE STREET
Mailing Address - Street 2:PO BOX 196
Mailing Address - City:OVERPECK
Mailing Address - State:OH
Mailing Address - Zip Code:45055
Mailing Address - Country:US
Mailing Address - Phone:513-444-0704
Mailing Address - Fax:
Practice Address - Street 1:515 DAYTON ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45011-3455
Practice Address - Country:US
Practice Address - Phone:513-896-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OH171M00000X
OHS.1600010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health