Provider Demographics
NPI:1649456096
Name:BOWMAN, JAYNE ALBERTA (LPC, BCPC)
Entity type:Individual
Prefix:MS
First Name:JAYNE
Middle Name:ALBERTA
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:LPC, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 E 71ST ST
Mailing Address - Street 2:256
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3922
Mailing Address - Country:US
Mailing Address - Phone:918-289-7827
Mailing Address - Fax:
Practice Address - Street 1:1831 E 71ST ST
Practice Address - Street 2:256
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3922
Practice Address - Country:US
Practice Address - Phone:918-289-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3030101YP2500X
OK653101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)