Active NPI
Dora Glenn Bowman, LCSW
- Clinical Social Worker
- Sunnyside, NY
National Provider Identifier
1245998905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 091825
- Practice address
- 3945 49TH St
Sunnyside, NY 11104-1023 - Phone
- (646) 286-5835
- NPI assigned
- Nov 30, 2021
- Last updated
- Nov 30, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 091825 | NY | Primary |
Addresses
Primary practice location
3945 49TH St
Sunnyside, NY 11104-1023
Mailing address
2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 1, 2022 through Aug 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091825 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1245998905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2855 TELEGRAPH AVE STE 515",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3945 49TH ST",
"city": "SUNNYSIDE",
"state": "NY",
"postal_code": "111041023",
"telephone_number": "646-286-5835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "DORA",
"middle_name": "GLENN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-30",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "091825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.