Healthcare Provider Details

I. General information

NPI: 1477712370
Provider Name (Legal Business Name): LINDA D BOWERS LCSW PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N STE 309
SAINT PETERSBURG FL
33702-4305
US

IV. Provider business mailing address

7901 4TH ST N STE 309
SAINT PETERSBURG FL
33702-4305
US

V. Phone/Fax

Practice location:
  • Phone: 727-329-6500
  • Fax: 727-329-6555
Mailing address:
  • Phone: 727-329-6500
  • Fax: 727-329-6555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW2164
License Number StateFL

VIII. Authorized Official

Name: LINDA D BOWERS
Title or Position: PRESIDENT
Credential: LCSW
Phone: 727-329-6500