Individual provider Active NPI

Julieanna Bowen, OTR/L

  • Psychologist
  • Lakeville, MN
National Provider Identifier
1275534505
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6908 Issued in MN
Practice address
10567 165TH St W Ste 260
Lakeville, MN 55044-3524
Phone
(527) 679-3749
Fax
(855) 538-0663
NPI assigned
Aug 9, 2005
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 103171 MN
Psychologist 103T00000X 6908 MN Primary

Addresses

Primary practice location

10567 165TH St W Ste 260
Lakeville, MN 55044-3524

Mailing address

10567 165TH St W
Lakeville, MN 55044-3523
Phone (952) 767-9374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250716001672 MN Practitioner - Clinical Psychologist 7810158961 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mears Psychological LLC Psychologist CurrentSince Jun 9, 2025 Accepting new patients

Locations

10567 165th St W
Lakeville, MN 55044
Phone (952) 767-9374

10567 165th St W
Ste 260
Lakeville, MN 55044
Phone (527) 679-3749

10567 165th St W
Ste B
Lakeville, MN 55044
Phone (952) 767-9374

1140 Robert St S
West St Paul, MN 55118
Phone (651) 243-0181

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1275534505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10567 165TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443523",
            "telephone_number": "952-767-9374",
            "fax_number": "855-538-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10567 165TH ST W STE 260",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443524",
            "telephone_number": "527-679-3749",
            "fax_number": "855-538-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "JULIEANNA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "103171",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "6908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.