Provider Demographics
NPI:1891160271
Name:BOWENS, MONICA HAYNES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:HAYNES
Last Name:BOWENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:WALLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9879 ROCKFISH RD
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-6727
Mailing Address - Country:US
Mailing Address - Phone:910-257-1537
Mailing Address - Fax:
Practice Address - Street 1:15 REGIONAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8850
Practice Address - Country:US
Practice Address - Phone:910-235-3406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0115831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical