Provider Demographics
NPI:1063601516
Name:BOWE, TRESSY J (LPC)
Entity type:Individual
Prefix:MS
First Name:TRESSY
Middle Name:J
Last Name:BOWE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 OLD RICHMOND AVE
Mailing Address - Street 2:G-30
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1828
Mailing Address - Country:US
Mailing Address - Phone:804-571-0717
Mailing Address - Fax:804-288-0705
Practice Address - Street 1:5700 OLD RICHMOND AVE
Practice Address - Street 2:G-30
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1828
Practice Address - Country:US
Practice Address - Phone:804-571-0717
Practice Address - Fax:804-288-0705
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003725101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945425Medicaid