Provider Demographics
NPI:1962284083
Name:BOWDEN, MAURESHA MARCHELL (LMSW)
Entity type:Individual
Prefix:
First Name:MAURESHA
Middle Name:MARCHELL
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MAURESHA
Other - Middle Name:MARCHELL
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 871
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:GA
Mailing Address - Zip Code:30272-0871
Mailing Address - Country:US
Mailing Address - Phone:404-621-5956
Mailing Address - Fax:
Practice Address - Street 1:2774 COBB PKWY NW STE 109-140
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-3469
Practice Address - Country:US
Practice Address - Phone:770-693-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0090461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical