Provider Demographics
NPI:1598782195
Name:BOWLES-LYONS, PATRICIA MARIE (LCSW, LP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARIE
Last Name:BOWLES-LYONS
Suffix:
Gender:F
Credentials:LCSW, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 JORALEMON ST
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4306
Mailing Address - Country:US
Mailing Address - Phone:718-722-6146
Mailing Address - Fax:718-722-6217
Practice Address - Street 1:191 JORALEMON ST
Practice Address - Street 2:14TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4306
Practice Address - Country:US
Practice Address - Phone:718-722-6146
Practice Address - Fax:718-722-6217
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027661-1101YM0800X, 1041C0700X
NY000468-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000468-1OtherPSYCHOANALYST LICENSE
NYR027661-1OtherLCSW LICENSE