Provider Demographics
NPI:1306958434
Name:BOWMAN, ROBLEY KIVETTE II (MA LPA)
Entity type:Individual
Prefix:MR
First Name:ROBLEY
Middle Name:KIVETTE
Last Name:BOWMAN
Suffix:II
Gender:M
Credentials:MA LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 SWEET OLIVE COURT
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-606-1862
Mailing Address - Fax:
Practice Address - Street 1:1725 SOUTH MAIN STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587
Practice Address - Country:US
Practice Address - Phone:919-556-6501
Practice Address - Fax:919-556-4933
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2245101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC046MJOtherBCBS
NC046MJOtherNC HEALTH CHOICE
NC6107139Medicaid
NC8236OtherFIVE COUNTY MENTAL HEALTH