Individual provider Active NPI

Kaitlin Bowen, MA, LMHC

  • Mental Health Counselor
  • Longwood, FL
National Provider Identifier
1639829021
Registry record updated May 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
20404 Issued in FL
Practice address
2965 W State Road 434 Ste 200
Longwood, FL 32779-4454
Phone
(407) 786-1913
NPI assigned
Mar 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 20404 FL Primary

Addresses

Primary practice location

2965 W State Road 434 Ste 200
Longwood, FL 32779-4454

Mailing address

2965 W Sr 434 Ste 200
Longwood, FL 32779-4454
Phone (407) 900-1463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251211002770 FL Practitioner - Mental Health Counselor 7214421726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1007 Alluvial Way
South Elgin, IL 60177-1781

2989 W Sr
434 Suite 100
Longwood, FL 32779-4898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
20404FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Promise of Hope Counseling Inc CurrentSince Oct 26, 2025 Accepting new patients
My Freedom Quest, Inc. PastSince Oct 26, 2025 Accepting new patients

Locations

2989 W State Road 434
Ste 100
Longwood, FL 32779
Phone (407) 786-1913

Organizations & group practices 2

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778889600000",
    "number": "1639829021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W SR 434 STE 200",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794454",
            "telephone_number": "407-900-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 W STATE ROAD 434 STE 200",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794454",
            "telephone_number": "407-786-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "KAITLIN",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "20404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.