Provider Demographics
NPI:1295923332
Name:BOWES, MICHELLE J (PHD IMFT-SUP, LPCC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:J
Last Name:BOWES
Suffix:
Gender:F
Credentials:PHD IMFT-SUP, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 WADSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9503
Mailing Address - Country:US
Mailing Address - Phone:234-206-1221
Mailing Address - Fax:330-334-2235
Practice Address - Street 1:140 WADSWORTH ROAD
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281
Practice Address - Country:US
Practice Address - Phone:234-206-1221
Practice Address - Fax:330-334-2235
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF1100004.SUPV101YM0800X
OHC0602175101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional