Provider Demographics
NPI:1417443508
Name:BOWSHER, MEGAN MUCHELLE (LISW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MUCHELLE
Last Name:BOWSHER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 VINE ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-1251
Mailing Address - Country:US
Mailing Address - Phone:567-226-1175
Mailing Address - Fax:
Practice Address - Street 1:105 VINE ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:OH
Practice Address - Zip Code:45817-1251
Practice Address - Country:US
Practice Address - Phone:567-226-1175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH166538101YA0400X
104100000X
OHI.25066881041C0700X
OHS.21066981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0456739Medicaid
OHI.2506688OtherLICENSE