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NPI Code Detail

MEDICARE: MRS. MICHELE BOWERSOX LPC, LMHC

MEDICARE:  MRS. MICHELE  BOWERSOX  LPC, LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor006880NY

General Provider Information

NPI Number : 1275989295
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELE BOWERSOX LPC, LMHC
Provider Business Mailing Address
First Line : 671 EXCHANGE ST
Second Line :
City : GENEVA
State : NY
Zip : 14456-3414
Country : US
Telephone Number : 315-789-2613
Fax Number : 315-789-2524
Provider Business Practice Location Address
First Line : 111 MASON ST
Second Line :
City : NEWARK
State : NY
Zip : 14513-1459
Country : US
Telephone Number : 315-331-8493
Fax Number : 315-331-6013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2016
Last Update Date : 05/09/2016

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Directions to “ MRS. MICHELE BOWERSOX LPC, LMHC” Practice Location

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