Provider Demographics
NPI:1851001051
Name:BOWMAN, LAKEIA J (LMHC)
Entity Type:Individual
Prefix:
First Name:LAKEIA
Middle Name:J
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98120 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4357
Mailing Address - Country:US
Mailing Address - Phone:774-608-9907
Mailing Address - Fax:
Practice Address - Street 1:1912 KENSINGTON CT
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-6544
Practice Address - Country:US
Practice Address - Phone:518-506-9836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health