Individual provider Active NPI

Marylyn Beeson Bowman, LCSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1124254990
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904015512 Issued in VA
Practice address
1099 18TH St Ste 8000
Denver, CO 80202-1908
Phone
(844) 257-1461
NPI assigned
Jun 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSW0000004943 TN
Clinical Social Worker 1041C0700X 0904015512 VA Primary

Addresses

Primary practice location

1099 18TH St Ste 8000
Denver, CO 80202-1908

Mailing address

1099 18TH St Ste 8000
Denver, CO 80202-1908
Phone (844) 257-1461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204000578 VA Practitioner - Clinical Social Worker 5193173060 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Florida International Univ, College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rock Landing Psychological Group PLCGroup PAC ID 1052209954, 19 clinicians
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

11825 Rock Landing Dr
Newport News, VA 23606-4236
Phone (757) 873-1736

999 Waterside Dr
Suite 2525
Norfolk, VA 23510-3316
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW0000004943TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Nov 7, 2024 Accepting new patients
Rock Landing Psychological Group PLC Clinical CurrentSince Nov 9, 2023 Accepting new patients

Locations

11825 Rock Landing Dr
Newport News, VA 23606
Phone (757) 873-1736

999 Waterside Dr
Ste 2525
Norfolk, VA 23510
Phone (757) 777-3787

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1244246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1124254990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 18TH ST STE 8000",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021908",
            "telephone_number": "844-257-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 18TH ST STE 8000",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021908",
            "telephone_number": "844-257-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "MARYLYN",
        "middle_name": "BEESON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-06",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004943",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.