Active NPI
Quinette Bowman
- Counselor
- Troy, MI
National Provider Identifier
1124635909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1777 Axtell Dr
Troy, MI 48084-4404 - Phone
- (248) 787-0855
- NPI assigned
- Sep 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401017523 | MI | |
| Professional Counselor | 101YP2500X | 6401017523 | MI | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1777 Axtell Dr
Troy, MI 48084-4404
Mailing address
21440 Westhampton St
Oak Park, MI 48237-2791
Phone (313) 952-3764
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6401017523 | MI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1124635909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21440 WESTHAMPTON ST",
"city": "OAK PARK",
"state": "MI",
"postal_code": "482372791",
"telephone_number": "313-952-3764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1777 AXTELL DR",
"city": "TROY",
"state": "MI",
"postal_code": "480844404",
"telephone_number": "248-787-0855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "QUINETTE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-25",
"last_updated": "2022-11-14",
"certification_date": "2022-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401017523",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401017523",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.