Provider Demographics
NPI:1689962847
Name:BOWERMAN, CARRIE ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:BOWERMAN
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:PO BOX 1291
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-1291
Mailing Address - Country:US
Mailing Address - Phone:717-461-0685
Mailing Address - Fax:
Practice Address - Street 1:543 HARVEST LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4487
Practice Address - Country:US
Practice Address - Phone:717-461-0685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9916091041C0700X
PACW0180651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical