Provider Demographics
NPI:1023663911
Name:ANGELA BOWERS
Entity type:Organization
Organization Name:ANGELA BOWERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LCMHC
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:919-559-3740
Mailing Address - Street 1:2024 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612
Mailing Address - Country:US
Mailing Address - Phone:919-559-3740
Mailing Address - Fax:919-800-0360
Practice Address - Street 1:6604 SIX FORKS RD
Practice Address - Street 2:SUITE 202
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615
Practice Address - Country:US
Practice Address - Phone:919-559-3740
Practice Address - Fax:919-800-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty