Active NPI
Ellen Rudge Bowman, LCPC
- Mental Health Counselor
- Augusta, ME
National Provider Identifier
1730396227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC234
- Practice address
- 12 Shuman Ave
Suite 18
Augusta, ME 04330-6020 - Phone
- (207) 621-0646
- Fax
- (207) 621-6861
- NPI assigned
- May 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC234 | ME | Primary |
Addresses
Primary practice location
12 Shuman Ave
Suite 18
Augusta, ME 04330-6020
Mailing address
190 Thundercastle Rd
Readfield, ME 04355-3702
Phone (207) 685-9087
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LICENSE # CC234 | Other | ME | CLINICAL COUNSELOR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC234 | ME | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730396227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 THUNDERCASTLE RD",
"city": "READFIELD",
"state": "ME",
"postal_code": "043553702",
"telephone_number": "207-685-9087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 SHUMAN AVE",
"address_2": "SUITE 18",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043306020",
"telephone_number": "207-621-0646",
"fax_number": "207-621-6861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "ELLEN",
"middle_name": "RUDGE",
"name_prefix": "Ms.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ME",
"license": "CC234",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL COUNSELOR",
"identifier": "LICENSE # CC234",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.