Benjamin Bowman
Individual provider Active NPI Mental Health Counselor · Timonium, MD
NPI 1144787201 · NPPES record last updated Apr 15, 2025
Key facts
- NPI
- 1144787201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LC11596 (MD)
- Practice address
- 30 Daria CT
Timonium, MD 21093-3044 - Phone
- (443) 232-1423
- NPI assigned
- Feb 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ADT1917 | MD | MD | Addiction (Substance Use Disorder) Counselor |
| LC11596 | MD | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lineout Therapy LLC | Current |
Accepting new patients |
Locations
57 W Timonium Rd
Ste 308
Timonium, MD 21093
57 W Timonium Rd
Timonium, MD 21093
Phone (410) 252-6400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ADT1917 | MD | |
| Mental Health Counselor | 101YM0800X | LC11596 | MD | Yes |
Addresses
Primary practice location
30 Daria CT
Timonium, MD 21093-3044
Mailing address
30 Daria CT
Timonium, MD 21093-3044
Phone (513) 720-5431
Other practice location 1
57 W Timonium Rd
Timonium, MD 21093-3125
Phone (443) 232-1423
Other providers in Timonium, MD
- Katie Elizabeth Boltz
- Wayne Russsell Bonlie
- Stephen David Bonwit
- Austin Joseph Schumann Bowden
- Tracy Austin Bowden
- Mark Aleksander Boyland
- Mark Bradford
- Michael Underwood Brady
- Tammy Brady
- Michele Braerman
All providers in Timonium, MD · Mental Health Counselor in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.