Provider Demographics
NPI:1912506957
Name:MARSHALL, BOWEN (LPC)
Entity Type:Individual
Prefix:DR
First Name:BOWEN
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5659 TRAVIS POINTE CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7201
Mailing Address - Country:US
Mailing Address - Phone:913-375-8654
Mailing Address - Fax:
Practice Address - Street 1:5354 N HIGH ST STE 206
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1274
Practice Address - Country:US
Practice Address - Phone:614-948-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1005915101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional