Healthcare Provider Details

I. General information

NPI: 1710722418
Provider Name (Legal Business Name): CAROLINE BOWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BAY AVE
SOMERS POINT NJ
08244-2553
US

IV. Provider business mailing address

60 W LANDIS AVE
VINELAND NJ
08360-8132
US

V. Phone/Fax

Practice location:
  • Phone: 609-788-0771
  • Fax:
Mailing address:
  • Phone: 856-772-5809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: