Provider Demographics
NPI:1760905467
Name:BOWERS, MEGAN RENEE (LISW-S)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENEE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RENEE
Other - Last Name:HUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:11271 STATE ROUTE 762
Mailing Address - Street 2:
Mailing Address - City:ORIENT
Mailing Address - State:OH
Mailing Address - Zip Code:43146-9005
Mailing Address - Country:US
Mailing Address - Phone:614-877-7436
Mailing Address - Fax:
Practice Address - Street 1:11271 STATE ROUTE 762
Practice Address - Street 2:
Practice Address - City:ORIENT
Practice Address - State:OH
Practice Address - Zip Code:43146-9005
Practice Address - Country:US
Practice Address - Phone:614-877-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1451344-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000000000OtherN/A