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General NPI Number Information
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NPI Number | 1023663911
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Entity Type | Organization
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Legal Business Name | ANGELA BOWERS
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 6604 SIX FORKS RD SUITE 202
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City | RALEIGH
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State | NC
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Zip | 27615
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Country | US
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Telephone | 919-559-3740
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Fax | 919-800-0360
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Provider Business Mailing Address
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Address Line | 2024 LONGWOOD DR
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City | RALEIGH
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State | NC
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Zip | 27612
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Country | US
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Telephone | 919-559-3740
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Fax | 919-800-0360
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Authorized Official
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Title or Position | LCMHC
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Name | ANGELA BOWERS
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Credential | LCMHC
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Telephone | 919-559-3740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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