Individual provider Active NPI

Mykayla Bowser

  • Professional Counselor
  • Fayetteville, AR
National Provider Identifier
1114608452
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P2503004 Issued in AR
Practice address
1680 E Joyce Blvd
Fayetteville, AR 72703-6214
Phone
(479) 222-1690
NPI assigned
Jul 28, 2023
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X P2503004 AR Primary

Addresses

Primary practice location

1680 E Joyce Blvd
Fayetteville, AR 72703-6214

Mailing address

1757 N Merion Way Apt 106
Fayetteville, AR 72704-6598

Other practice location 1

34 W Colt Square Dr Ste 1
Fayetteville, AR 72703-2888
Phone (479) 595-0333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P2503004ARMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bowser Counseling LLC Professional CurrentSince Aug 10, 2025 Accepting new patients

Locations

1680 E Joyce Blvd
Fayetteville, AR 72703
Phone (479) 222-1690

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1114608452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 N MERION WAY APT 106",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 E JOYCE BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036214",
            "telephone_number": "479-222-1690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 W Colt Square Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727032888",
            "country_code": "US",
            "telephone_number": "479-595-0333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWSER",
        "first_name": "MYKAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2503004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.