Provider Demographics
NPI:1679742647
Name:BOWE, BARBARA J (MSW LICSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:BOWE
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PERTHSHIRE ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:617-789-5593
Mailing Address - Fax:617-482-9909
Practice Address - Street 1:1368 BEACON ST
Practice Address - Street 2:SUITE 115
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02146
Practice Address - Country:US
Practice Address - Phone:617-789-5593
Practice Address - Fax:617-482-9909
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10201971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO6253OtherBLUE CROSS BLUE SHIELD