Healthcare Provider Details

I. General information

NPI: 1114801990
Provider Name (Legal Business Name): ALYSSA BOWERS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 JEFFERSON ST
SIMPSON PA
18407-1207
US

IV. Provider business mailing address

41 JEFFERSON ST
SIMPSON PA
18407-1207
US

V. Phone/Fax

Practice location:
  • Phone: 570-581-1087
  • Fax:
Mailing address:
  • Phone: 570-581-1087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW143051
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: