Provider Demographics
NPI:1649559071
Name:BOWERSMITH, JOANNA (LMFT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:BOWERSMITH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 E ALGONQUIN RD
Mailing Address - Street 2:STE 207
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4185
Mailing Address - Country:US
Mailing Address - Phone:312-363-8792
Mailing Address - Fax:
Practice Address - Street 1:2010 E ALGONQUIN RD
Practice Address - Street 2:STE 207
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4185
Practice Address - Country:US
Practice Address - Phone:312-363-8792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166000841106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist