Provider Demographics
NPI:1134372675
Name:BOWDEN, STEPHANIE (LPC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 CHARLES DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-4442
Mailing Address - Country:US
Mailing Address - Phone:504-278-4006
Mailing Address - Fax:504-278-4007
Practice Address - Street 1:2626 CHARLES DRIVE
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4442
Practice Address - Country:US
Practice Address - Phone:504-278-4006
Practice Address - Fax:504-278-4007
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2999101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2999OtherLA LICENSE