MEDICARE: MR. WESLEY MARSHALL BOWMAN MSED, LPC

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	LPC.0012110	CO

General Provider Information

NPI Number	:	1962826974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WESLEY MARSHALL BOWMAN MSED, LPC

Provider Business Mailing Address
First Line	:	1182 GRAVES AVE UNIT C
Second Line	:	SUITE #2
City	:	ESTES PARK
State	:	CO
Zip	:	80517-7742
Country	:	US
Telephone Number	:	970-238-0268
Fax Number	:	970-692-2594

Provider Business Practice Location Address
First Line	:	1182 GRAVES AVE UNIT C
Second Line	:	SUITE #2
City	:	ESTES PARK
State	:	CO
Zip	:	80517-7742
Country	:	US
Telephone Number	:	970-238-0268
Fax Number	:	970-692-2594

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

Provider Enumeration Date	:	02/11/2014
Last Update Date	:	06/27/2016

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