1023055142 NPI number — MRS. MARY BROOKS BOWE MSW,ACSW,LCSW

Table of content: MRS. MARY BROOKS BOWE MSW,ACSW,LCSW (NPI 1023055142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023055142 NPI number — MRS. MARY BROOKS BOWE MSW,ACSW,LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWE
Provider First Name:
MARY
Provider Middle Name:
BROOKS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW,ACSW,LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023055142
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8207 ORANGE GROVE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27516-8887
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-929-5040
Provider Business Mailing Address Fax Number:
919-942-6884

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 CORAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GOLDSTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27252-9606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-898-2300
Provider Business Practice Location Address Fax Number:
919-898-4800
Provider Enumeration Date:
05/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  1041C0700X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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