Active NPI
Dwain Bowline, LMFT
- Marriage & Family Therapist
- Broken Arrow, OK
National Provider Identifier
1992942510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 586
- Practice address
- 716 S Main St
Broken Arrow, OK 74012-5527 - Phone
- (918) 367-1130
- Fax
- (918) 367-1180
- NPI assigned
- Jan 20, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 586 | OK | Primary |
Addresses
Primary practice location
716 S Main St
Broken Arrow, OK 74012-5527
Mailing address
PO Box 1078
Bristow, OK 74010-1078
Phone (918) 367-1130
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 |
|---|---|---|---|
| 586 | OK | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232409600000",
"number": "1992942510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1078",
"city": "BRISTOW",
"state": "OK",
"postal_code": "740101078",
"telephone_number": "918-367-1130",
"fax_number": "918-367-1180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 S MAIN ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740125527",
"telephone_number": "918-367-1130",
"fax_number": "918-367-1180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWLINE",
"first_name": "DWAIN",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-20",
"last_updated": "2009-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OK",
"license": "586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.