Provider Demographics
NPI:1023055142
Name:BOWE, MARY BROOKS (MSW,ACSW,LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BROOKS
Last Name:BOWE
Suffix:
Gender:F
Credentials:MSW,ACSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8207 ORANGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-8887
Mailing Address - Country:US
Mailing Address - Phone:919-929-5040
Mailing Address - Fax:919-942-6884
Practice Address - Street 1:40 CORAL AVE
Practice Address - Street 2:
Practice Address - City:GOLDSTON
Practice Address - State:NC
Practice Address - Zip Code:27252-9606
Practice Address - Country:US
Practice Address - Phone:919-898-2300
Practice Address - Fax:919-898-4800
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2874731Medicare ID - Type Unspecified
NCEXEMPTMedicare UPIN