Provider Demographics
NPI:1649899618
Name:LUKENBILL-BOWLES, JONNI ROSE (MS, LPC, NCC, BCC)
Entity type:Individual
Prefix:
First Name:JONNI
Middle Name:ROSE
Last Name:LUKENBILL-BOWLES
Suffix:
Gender:F
Credentials:MS, LPC, NCC, BCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-4717
Mailing Address - Country:US
Mailing Address - Phone:847-254-5425
Mailing Address - Fax:
Practice Address - Street 1:420 E POLK ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1237
Practice Address - Country:US
Practice Address - Phone:319-653-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional