Provider Demographics
NPI:1336377332
Name:BOWEN, PHILIP DON (MSW/LCSW)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:DON
Last Name:BOWEN
Suffix:
Gender:M
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 FLEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-6567
Mailing Address - Country:US
Mailing Address - Phone:405-210-2539
Mailing Address - Fax:
Practice Address - Street 1:518 FLEETWOOD DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-6567
Practice Address - Country:US
Practice Address - Phone:405-210-2539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical