Healthcare Provider Details

I. General information

NPI: 1396250692
Provider Name (Legal Business Name): SHAYLA A BOWEN MSW, LISW, LICDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 WHEELING AVE
CAMBRIDGE OH
43725-2316
US

IV. Provider business mailing address

2845 BELL ST
ZANESVILLE OH
43701-1720
US

V. Phone/Fax

Practice location:
  • Phone: 740-439-4428
  • Fax: 740-439-3389
Mailing address:
  • Phone: 740-454-9766
  • Fax: 740-588-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2405773
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.162099
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: