Provider Demographics
NPI:1770903213
Name:BOWES AND ASSOCIATES PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:BOWES AND ASSOCIATES PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-LCPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORIANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BOWES
Authorized Official - Suffix:
Authorized Official - Credentials:MA-LCPC
Authorized Official - Phone:240-237-8405
Mailing Address - Street 1:44680 TALL TIMBERS RD
Mailing Address - Street 2:
Mailing Address - City:TALL TIMBERS
Mailing Address - State:MD
Mailing Address - Zip Code:20690-2212
Mailing Address - Country:US
Mailing Address - Phone:240-237-8405
Mailing Address - Fax:240-237-8480
Practice Address - Street 1:21789 N CORAL DR
Practice Address - Street 2:SUITE 2A
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-5517
Practice Address - Country:US
Practice Address - Phone:240-237-8405
Practice Address - Fax:240-237-8480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD059436900Medicaid