Provider Demographics
NPI:1396971420
Name:BOWMAN, CELESTE (MS, CAP,)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MS, CAP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3490 QUANTUM LAKES DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8340
Mailing Address - Country:US
Mailing Address - Phone:718-213-6680
Mailing Address - Fax:
Practice Address - Street 1:3490 QUANTUM LAKES DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8340
Practice Address - Country:US
Practice Address - Phone:718-213-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11515101YA0400X
FLIMH20242101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIMH20242OtherFLORIDA CERTIFICATION BOARD
FL009621-2015OtherFLORIDA CERTIFICATION BOARD