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General NPI Number Information
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NPI Number | 1073291795
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Entity Type | Organization
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Legal Business Name | DWELL MINISTRY PC
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 2709 PINEDALE RD STE B
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City | GREENSBORO
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State | NC
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Zip | 27408-2018
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Country | US
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Telephone | 434-327-7624
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Fax |
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Provider Business Mailing Address
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Address Line | 2709 PINEDALE RD STE B
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City | GREENSBORO
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State | NC
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Zip | 27408-2018
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Country | US
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Telephone | 434-327-7624
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, CLINICAL THERAPIST
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Name | LAUREN BOWMAN
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Credential | MA, LCMHC
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Telephone | 317-746-8900
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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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