Marianna Bowen, LCMHC
Individual provider Active NPI Mental Health Counselor · Clemmons, NC
NPI 1982170619 · NPPES record last updated Jan 23, 2024
Key facts
- NPI
- 1982170619
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 14269 (NC)
- Practice address
- 3540 Clemmons Rd Ste 124
Clemmons, NC 27012-9396 - Phone
- (336) 422-7882
- NPI assigned
- Oct 20, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241115002924 | NC | Practitioner - Mental Health Counselor | 3971037755 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14269 | NC | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14269 | NC | Yes |
Addresses
Primary practice location
3540 Clemmons Rd Ste 124
Clemmons, NC 27012-9396
Mailing address
5800 Sir Knight Cir
Clemmons, NC 27012-8364
Phone (336) 749-9384
Other providers in Clemmons, NC
- Aubrey Gayle Boos
- Holly Antony Borders
- Jessica Diane Born
- Margo Born
- Leslie Jean Boucherle
- Catherine R Bradford
- Sukhdev Singh Brar
- Madeline Gautreaux Brence
- Rachel Hannah Bretz
- Brianna Alexis Brigman
All providers in Clemmons, NC · Mental Health Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.