Provider Demographics
NPI:1336825793
Name:BOWDEN, CASEY LEANN (LCMHC)
Entity Type:Individual
Prefix:MS
First Name:CASEY
Middle Name:LEANN
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 RASPBERRY RDG APT 207
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-8521
Mailing Address - Country:US
Mailing Address - Phone:765-702-4575
Mailing Address - Fax:
Practice Address - Street 1:18809 W CATAWBA AVE STE 202
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5548
Practice Address - Country:US
Practice Address - Phone:704-840-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health