Individual provider Active NPI

Courtney R Bowerman, LCSW-C

  • Clinical Social Worker
  • Rosedale, MD
National Provider Identifier
1912567090
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22235 Issued in MD
Practice address
9627 Philadelphia Rd
Rosedale, MD 21237-4154
Phone
(410) 780-4320
NPI assigned
Jun 19, 2019
Last updated
Jun 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22235 MD Primary

Addresses

Primary practice location

9627 Philadelphia Rd
Rosedale, MD 21237-4154

Mailing address

9627 Philadelphia Rd
Rosedale, MD 21237-4154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20210128002484 MD Practitioner - Clinical Social Worker 4789098930 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Behavioral Health, LLC CurrentSince Jan 1, 2021 Accepting new patients
Thrive Behavioral Health, LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

1114 Benfield Blvd
Ste G
Millersville, MD 21108
Phone (410) 780-4320

9627 Philadelphia Rd
Ste 160
Rosedale, MD 21237
Phone (410) 780-5205

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1912567090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9627 PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9627 PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374154",
            "telephone_number": "410-780-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERMAN",
        "first_name": "COURTNEY",
        "middle_name": "R",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

Verify at the official NPI Registry.