Provider Demographics
NPI:1427318237
Name:BOWIE, SUDEEPTHA G (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUDEEPTHA
Middle Name:G
Last Name:BOWIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 CITY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-3723
Mailing Address - Country:US
Mailing Address - Phone:504-250-3337
Mailing Address - Fax:504-322-2576
Practice Address - Street 1:1172 CITY PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-3723
Practice Address - Country:US
Practice Address - Phone:504-250-3337
Practice Address - Fax:504-322-2576
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA50011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical