Healthcare Provider Details

I. General information

NPI: 1194620369
Provider Name (Legal Business Name): BROOKE BOWENS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5170 WINCHESTER SOUTHERN RD
CANAL WINCHESTER OH
43110-7917
US

IV. Provider business mailing address

8584 ERIE LOOP
CANAL WINCHESTER OH
43110-3552
US

V. Phone/Fax

Practice location:
  • Phone: 614-442-7650
  • Fax:
Mailing address:
  • Phone: 614-917-8507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2406560
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: