Provider Demographics
NPI:1669998548
Name:BOWLIN, MORGAN FRAZIER (LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:FRAZIER
Last Name:BOWLIN
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 MEADOW SPRING DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-2047
Mailing Address - Country:US
Mailing Address - Phone:865-776-6761
Mailing Address - Fax:
Practice Address - Street 1:1515 MEADOW SPRING DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-2047
Practice Address - Country:US
Practice Address - Phone:865-776-6761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
TN6060101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor