Provider Demographics
NPI:1609973288
Name:NOWLIN, BRAD (LMFT)
Entity Type:Individual
Prefix:MR
First Name:BRAD
Middle Name:
Last Name:NOWLIN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 W 128TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-3018
Mailing Address - Country:US
Mailing Address - Phone:913-579-8526
Mailing Address - Fax:817-886-8489
Practice Address - Street 1:550 BAILEY AVE
Practice Address - Street 2:235
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2155
Practice Address - Country:US
Practice Address - Phone:913-579-8526
Practice Address - Fax:817-886-8489
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS326106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist