Healthcare Provider Details

I. General information

NPI: 1043826936
Provider Name (Legal Business Name): JOSHUA BRINTON BOWMAN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N 6TH ST
HARRISBURG PA
17102-1703
US

IV. Provider business mailing address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

V. Phone/Fax

Practice location:
  • Phone: 717-233-4027
  • Fax:
Mailing address:
  • Phone: 717-560-7917
  • Fax: 717-560-6152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC012553
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: