1871734327 NPI number — BRUCE EDWARD BOWER MA, MSW, LMSW, DCSW

NPI Number: 1871734327
Health Care Provider/Practitioner: BRUCE EDWARD BOWER MA, MSW, LMSW, DCSW

NPI Number : 1871734327 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871734327",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BOWER",
    "FirstName": "BRUCE",
    "MiddleName": "EDWARD",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "MA, MSW, LMSW, DCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6 LOCUST LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LANSING",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48911-1152",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "517-887-9875",
    "MailingAddressFaxNumber": "517-579-0287",
    "FirstLinePracticeLocationAddress": "6 LOCUST LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LANSING",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48911-1152",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "517-887-9875",
    "PracticeLocationAddressFaxNumber": "517-579-0287",
    "EnumerationDate": "03/12/2009",
    "LastUpdateDate": "07/05/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "6801035092",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "1041S0200X",
          "TaxonomyName": "School Social Worker",
          "LicenseNumber": "6801035092",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}