Provider Demographics
NPI:1740032903
Name:BOWEN, JOSHUA S (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:S
Last Name:BOWEN
Suffix:
Gender:M
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 BEECHWOOD VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-9902
Mailing Address - Country:US
Mailing Address - Phone:616-633-1507
Mailing Address - Fax:
Practice Address - Street 1:2237 BEECHWOOD VIEW DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-9902
Practice Address - Country:US
Practice Address - Phone:616-633-1507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0152981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty