Provider Demographics
NPI:1669862637
Name:BOWLING, AMANDA (LPCC-S)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:
Last Name:BOWLING
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24100 CHAGRIN BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5552
Mailing Address - Country:US
Mailing Address - Phone:330-595-4590
Mailing Address - Fax:216-245-6770
Practice Address - Street 1:24100 CHAGRIN BLVD STE 330
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5552
Practice Address - Country:US
Practice Address - Phone:330-595-4590
Practice Address - Fax:216-245-6770
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1400595101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC.1400595-TRNEOtherC.1400595-TRNE (COUNSELOR TRAINEE)