Lisa D Bowen, MA ED.S

Primary specialty

PsychologistTaxonomy code 103T00000X

License

11112 Issued in WV

Practice address

2850 5TH Ave
Huntington, WV 25702-1436

Phone

(304) 528-5000

Fax

(304) 528-5080

NPI assigned

Jan 30, 2008

Sex

Female

Sole proprietor

Yes

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.

• Cabell County Board of Education

  • Local Education Agency (LEA)
  • Huntington, WV
  • NPI 1417153495
  NPD (past)
• Cabell County Board of Education

  • Local Education Agency (LEA)
  • Huntington, WV
  • NPI 1609045657
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 30, 2008.

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1437336591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 SYCAMORE RD",
            "city": "CULLODEN",
            "state": "WV",
            "postal_code": "255109316",
            "telephone_number": "304-562-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 5TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021436",
            "telephone_number": "304-528-5000",
            "fax_number": "304-528-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "LISA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "MA ED.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "11112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9489007000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charley William Bowen Jr., M.A.
• Derrick Bowen, MA
• Destney L Bowen
• Jayson Bowen
• Jennifer Bowen, MA/CCC-SLP
• Olivia Shae Bowen
• Allison Bowens
• Amie L Bowling
• Kaitlin Elizabeth Bowling
• Alicia Lyn Bowman

• All providers in Huntington, WV
• Psychologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.