Zetta K Bowles, PSY. D.
Individual provider Active NPI Clinical Psychologist · Laurel Fork, VA
NPI 1992832547 · NPPES record last updated Oct 11, 2025
Key facts
- NPI
- 1992832547
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0810004791 (VA)
- Practice address
- 14558 Danville Pike
Laurel Fork, VA 24352-3982 - Phone
- (276) 398-2292
- Fax
- (276) 398-3331
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tri Area Community Health
Practice addresses (Care Compare)
14558 Danville Pike
Laurel Fork, VA 24352-3982
Phone (276) 398-2292
PO Box
Suite 9
Laurel Fork, VA 24352
PO Box
Suite 9
Laurel Fork, VA 24352-0009
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- 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 |
|---|---|---|---|---|
| I20180212001599 | VA | Practitioner - Clinical Psychologist | 8022378058 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri Area Community Health | Current | Accepting new patients | |
| Heatherwood Counseling Center, Inc. | Current |
Accepting new patients | |
| Tri Area Community Health | Current |
Accepting new patients | |
| Tri Area Community Health | Current |
Accepting new patients |
Locations
140 Christiansburg Pike NE
Floyd, VA 24091
Phone (540) 745-9290
14558 Danville Pike
Laurel Fork, VA 24352
Phone (276) 398-1200
14558 Danville Pike
#9
Laurel Fork, VA 24352
Phone (540) 398-2292
434 Mitchell Valley Dr
Marion, VA 24354
Phone (276) 783-7600
Interoperability endpoints
- zetta.bowles@tachc.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810004791 | VA | |
| Clinical Psychologist | 103TC0700X | 0810004791 | VA | Yes |
Addresses
Primary practice location
14558 Danville Pike
Laurel Fork, VA 24352-3982
Mailing address
PO Box 9
Laurel Fork, VA 24352-0009
Phone (276) 398-1200
Other practice location 1
140 Christiansburg Pike NE
Floyd, VA 24091-3742
Phone (540) 745-9290
Other practice location 2
109 Virginia Highlander Rd
Sugar Grove, VA 24375-3062
Phone (304) 661-2070
Other names
- Dr. Zetta K Nicely
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | wedonotusethis |
Other providers in Laurel Fork, VA
- Crystal B Alderman
- Jordan Anders
- John D Barnett
- William R Bess Jr.
- Bethany Pearl Brintle
- Cindy Lee Brooms
- Rachel Ellen Carter
- Donna Gibson
- Mary Caroniti Hansen
All providers in Laurel Fork, VA · Clinical Psychologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2025. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.