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General NPI Number Information
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NPI Number | 1548734023
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Entity Type | Individual
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Provider Name | LORNA BEVERLY BOWEN LPC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 2140 MCGEE RD STE C700
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City | SNELLVILLE
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State | GA
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Zip | 30078-7018
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Country | US
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Telephone | 404-547-1960
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Fax | 770-680-5715
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Provider Business Mailing Address
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Address Line | 6194 WATERTON WAY
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City | LITHONIA
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State | GA
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Zip | 30058-3520
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Country | US
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Telephone | 404-547-1960
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Fax | 770-680-5715
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC008065
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT001342
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License Number State | GA
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