Individual provider Active NPI

Melissa Bowman, MA, LMFT

  • Marriage & Family Therapist
  • Meridian, ID
National Provider Identifier
1508112707
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 51163 Issued in CA
Practice address
6700 N Linder Rd Ste 156-119
Meridian, ID 83646-6606
Phone
(208) 391-3160
Fax
(855) 745-3595
NPI assigned
Jul 25, 2012
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT7109 ID
Marriage & Family Therapist 106H00000X MFC 51163 CA Primary

Addresses

Primary practice location

6700 N Linder Rd Ste 156-119
Meridian, ID 83646-6606

Mailing address

6700 N Linder Rd Ste 156-119
Meridian, ID 83646-6606
Phone (208) 391-3160

Other practice location 1

53 N Plummer Rd Ste 6
Star, ID 83669-5561
Phone (208) 391-3160

Other practice location 2

53 N Plummer Rd Ste 6
Star, ID 83669-5561
Phone (208) 391-3160

Other practice location 3

27851 Bradley Road
Suite 111
Menifee, CA 92586
Phone (951) 370-0785

Other practice location 4

27851 Bradley Rd Ste 103
Menifee, CA 92586-2213
Phone (951) 370-0785

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC 51163CAMDMarriage & Family Therapist
MFT7109IDMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1508112707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 N LINDER RD STE 156-119",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466606",
            "telephone_number": "208-391-3160",
            "fax_number": "855-745-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N LINDER RD STE 156-119",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466606",
            "telephone_number": "208-391-3160",
            "fax_number": "855-745-3595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53 N Plummer Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Star",
            "state": "ID",
            "postal_code": "836695561",
            "country_code": "US",
            "telephone_number": "208-391-3160",
            "fax_number": "855-745-3595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53 N Plummer Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Star",
            "state": "ID",
            "postal_code": "836695561",
            "country_code": "US",
            "telephone_number": "208-391-3160",
            "fax_number": "855-745-3595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27851 Bradley Road",
            "address_2": "Suite 111",
            "address_purpose": "LOCATION",
            "city": "Menifee",
            "state": "CA",
            "postal_code": "92586",
            "country_code": "US",
            "telephone_number": "951-370-0785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27851 Bradley Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Menifee",
            "state": "CA",
            "postal_code": "925862213",
            "country_code": "US",
            "telephone_number": "951-370-0785",
            "fax_number": "855-745-3595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "MFT7109",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 51163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.