Healthcare Provider Details

I. General information

NPI: 1225958192
Provider Name (Legal Business Name): DOMINIQUE BOWLEN MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8380 ZUNI ST
DENVER CO
80221-4778
US

IV. Provider business mailing address

9023 UTICA ST
WESTMINSTER CO
80031-3146
US

V. Phone/Fax

Practice location:
  • Phone: 720-378-8550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022131
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: