Provider Demographics
NPI:1699199398
Name:BOWLEY, SHERRY (LPC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:BOWLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:TATMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:363 SAGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-6918
Mailing Address - Country:US
Mailing Address - Phone:479-518-4674
Mailing Address - Fax:479-308-0266
Practice Address - Street 1:1305 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-5322
Practice Address - Country:US
Practice Address - Phone:479-518-4674
Practice Address - Fax:479-518-4674
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-15
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1705309101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional