Provider Demographics
NPI:1558659672
Name:BOWEN, KATHRYN ANN (LCPC)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ANN
Last Name:BOWEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:KITTIE
Other - Middle Name:ANN
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:695 SYCAMORE LN
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-9496
Mailing Address - Country:US
Mailing Address - Phone:406-570-1424
Mailing Address - Fax:
Practice Address - Street 1:2023 STADIUM DR STE 2A
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-0613
Practice Address - Country:US
Practice Address - Phone:406-570-1424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1579-LCPC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional