Provider Demographics
NPI:1063695443
Name:BOWERS, JESSICA D (LCSW)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:D
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 FLAMINGO PL
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-1754
Mailing Address - Country:US
Mailing Address - Phone:352-661-5967
Mailing Address - Fax:
Practice Address - Street 1:1425 S US 301
Practice Address - Street 2:
Practice Address - City:SUMTERVILLE
Practice Address - State:FL
Practice Address - Zip Code:33585-5141
Practice Address - Country:US
Practice Address - Phone:352-793-5900
Practice Address - Fax:352-793-6269
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-09
Last Update Date:2019-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW6351 (LCSW)1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical