Provider Demographics
NPI:1578705893
Name:BOWEN, SYLVIA (LCSW)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2979 COUNTY ROAD 222
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-8166
Mailing Address - Country:US
Mailing Address - Phone:970-889-7116
Mailing Address - Fax:
Practice Address - Street 1:317 BUNKER AVE
Practice Address - Street 2:
Practice Address - City:AZTEC
Practice Address - State:NM
Practice Address - Zip Code:87410-2307
Practice Address - Country:US
Practice Address - Phone:208-260-2821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-087981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical