Individual provider Active NPI

Lee A. Bowers, PH.D.

  • Clinical Psychologist
  • Villanova, PA
National Provider Identifier
1184621930
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS-006234-L Issued in PA
Practice address
210 Tower Rd
Villanova, PA 19085
Phone
(610) 520-0443
Fax
(610) 520-0442
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS-006234-L PA
Health Service Psychologist 103TH0100X PS-006234-L PA
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PS-006234-L PA Primary

Addresses

Primary practice location

210 Tower Rd
Villanova, PA 19085

Mailing address

210 Tower Rd
Villanova, PA 19085-1214
Phone (610) 520-0443

Other identifiers 1

IdentifierTypeStateIssuer
BO 063245OtherPABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20071019000381 PA Practitioner - Clinical Psychologist 5597851626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

210 Tower Rd
Villanova, PA 19085-1214
Phone (610) 520-0443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS-006234-LPAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Psychological Services, Inc. Single Specialty CurrentSince Jan 1, 2007 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1184621930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 TOWER RD",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851214",
            "telephone_number": "610-520-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 TOWER RD",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "19085",
            "telephone_number": "610-520-0443",
            "fax_number": "610-520-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "LEE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS-006234-L",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "PA",
            "license": "PS-006234-L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-006234-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "BO 063245",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Villanova, PA

Sources for this page

Verify at the official NPI Registry.