Healthcare Provider Details

I. General information

NPI: 1134287964
Provider Name (Legal Business Name): JOHN N BOWMAN LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 WASHINGTON STREET
PORTSMOUTH OH
45662
US

IV. Provider business mailing address

901 WASHINGTON ST
PORTSMOUTH OH
45662-3944
US

V. Phone/Fax

Practice location:
  • Phone: 740-354-7702
  • Fax: 740-353-1662
Mailing address:
  • Phone: 740-354-7702
  • Fax: 740-353-1662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0000162-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberE000162
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: