Provider Demographics
NPI:1700558426
Name:BOWEN, KATHERINE ANNE HARTMAN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANNE HARTMAN
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1953
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23218-1953
Mailing Address - Country:US
Mailing Address - Phone:804-405-6723
Mailing Address - Fax:
Practice Address - Street 1:11733 BOWMAN GREEN DR STE 200
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3501
Practice Address - Country:US
Practice Address - Phone:804-405-6723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040074241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical