Provider Demographics
NPI:1629108345
Name:BOWIE, CHERYL L (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:BOWIE
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 1:2700 TIBBETS DR
Mailing Address - Street 2:SUITE 408
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-5928
Mailing Address - Country:US
Mailing Address - Phone:817-545-8895
Mailing Address - Fax:817-545-8897
Practice Address - Street 1:2700 TIBBETS DR
Practice Address - Street 2:SUITE 408
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-5928
Practice Address - Country:US
Practice Address - Phone:817-545-8895
Practice Address - Fax:817-545-8897
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16979101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist