Provider Demographics
NPI:1548739501
Name:BOWMAN, DONNA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4430
Mailing Address - Country:US
Mailing Address - Phone:301-676-3522
Mailing Address - Fax:
Practice Address - Street 1:1501 N MARKET ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4430
Practice Address - Country:US
Practice Address - Phone:301-676-3522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD089151041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD08915OtherBOARD OF SOCIAL WORK EXAMINERS