Provider Demographics
NPI:1528281789
Name:BOWDEN, JOAN H (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:H
Last Name:BOWDEN
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 1:205 S WALNUT ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-6128
Mailing Address - Country:US
Mailing Address - Phone:812-345-8146
Mailing Address - Fax:
Practice Address - Street 1:205 S WALNUT ST
Practice Address - Street 2:SUITE 17
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-6128
Practice Address - Country:US
Practice Address - Phone:812-345-8146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003710A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical