Johanna Bowen, LCSW

Individual provider Active NPI Clinical Social Worker · Pomona, NY

NPI 1184765331 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1184765331
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
42150 (NY)
Practice address
50 Sanitorium Rd
BLDG H
Pomona, NY 10970-3555
Phone
(845) 364-2465
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
42150NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 42150 NY Yes

Addresses

Primary practice location

50 Sanitorium Rd
BLDG H
Pomona, NY 10970-3555

Mailing address

550 Bullville Rd
Montgomery, NY 12549-1825
Phone (845) 361-4749

Other providers in Pomona, NY

All providers in Pomona, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.