Provider Demographics
NPI:1336346592
Name:BOWN, CHRISTIAN TOMAS (LMHC)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:TOMAS
Last Name:BOWN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 NICHOLAS PL
Mailing Address - Street 2:C
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-9036
Mailing Address - Country:US
Mailing Address - Phone:219-588-0035
Mailing Address - Fax:
Practice Address - Street 1:1025 HERMOSA DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-4312
Practice Address - Country:US
Practice Address - Phone:505-237-0061
Practice Address - Fax:505-237-0068
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0103351101YM0800X
NM0142501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health