Provider Demographics
NPI:1194438689
Name:AMY BOWEN CMHC, LLC
Entity type:Organization
Organization Name:AMY BOWEN CMHC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:435-557-0655
Mailing Address - Street 1:297 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HYRUM
Mailing Address - State:UT
Mailing Address - Zip Code:84319-1602
Mailing Address - Country:US
Mailing Address - Phone:801-664-5259
Mailing Address - Fax:
Practice Address - Street 1:338 EAST 300 NORTH
Practice Address - Street 2:SUITE #1
Practice Address - City:HYDE PARK
Practice Address - State:UT
Practice Address - Zip Code:84318
Practice Address - Country:US
Practice Address - Phone:435-557-0655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health