Healthcare Provider Details

I. General information

NPI: 1346157229
Provider Name (Legal Business Name): COREY BOWLING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2939 KENNY RD STE 195
COLUMBUS OH
43221-2406
US

IV. Provider business mailing address

2939 KENNY RD STE 195
COLUMBUS OH
43221-2406
US

V. Phone/Fax

Practice location:
  • Phone: 614-957-0164
  • Fax:
Mailing address:
  • Phone: 614-957-0164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2608518
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: