Individual provider Active NPI

Charles Lee Bowman

  • Counselor
  • Princeton, WV
National Provider Identifier
1578049151
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
200 12TH Street Ext
Princeton, WV 24740-2329
Phone
(304) 425-9541
NPI assigned
Jul 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

200 12TH Street Ext
Princeton, WV 24740-2329

Mailing address

200 12TH Street Ext
Princeton, WV 24740-2329
Phone (304) 425-9541

Other identifiers 1

IdentifierTypeStateIssuer
0005489001MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20241213000542 WV Practitioner - Mental Health Counselor 6002342045 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Highlands Community Mental Health Center, Inc. Counselor CurrentSince Jul 1, 2024 Accepting new patients

Locations

102 Howard Ave
Mullens, WV 25882
Phone (304) 294-5353

200 12th Street Ext
Princeton, WV 24740
Phone (304) 425-9541

19805 Coal Heritage Rd
Welch, WV 24801
Phone (304) 425-9541

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1578049151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402329",
            "telephone_number": "304-425-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402329",
            "telephone_number": "304-425-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "CHARLES",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-17",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005489001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.