MEDICARE: PROF. COLLEEN M BOWLER M.ED., 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
1	101YM0800X	Mental Health Counselor	6106	MA

General Provider Information

NPI Number	:	1649434507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. COLLEEN M BOWLER M.ED., LMHC

Provider Business Mailing Address
First Line	:	52R STAFFORD ST, UNIT B
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-8114
Country	:	US
Telephone Number	:	781-910-4455
Fax Number	:

Provider Business Practice Location Address
First Line	:	52R STAFFORD ST, UNIT B
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-8114
Country	:	US
Telephone Number	:	781-910-4455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2008
Last Update Date	:	12/22/2025

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