| Charles Lee Bowman, | |
|
102 Howard Ave, Mullens, WV 25882-1419 | |
| (304) 294-5353 | |
| Not Available |
| Full Name | Charles Lee Bowman |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 102 Howard Ave, Mullens, West Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578049151 | NPI | - | NPPES |
| 0005489001 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Entity Name | Southern Highlands Community Mental Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740234673 PECOS PAC ID: 4486629235 Enrollment ID: O20040826000703 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Lee Bowman, 102 Howard Ave, Mullens, WV 25882-1419 Ph: (304) 294-5353 | Charles Lee Bowman, 102 Howard Ave, Mullens, WV 25882-1419 Ph: (304) 294-5353 |
Justin Tyler Bailey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Howard Ave, Mullens, WV 25882 Phone: 304-294-5353 Fax: 304-294-8627 | |
Jessica Lee Mitchell, Counselor Medicare: Not Enrolled in Medicare Practice Location: Po Box 195, Mullens, WV 25882 Phone: 304-207-2749 Fax: 304-923-2909 | |
Romaine Lentz, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Howard Ave, Mullens, WV 25882 Phone: 304-294-5353 | |
Katie Jo Williamson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Howard Ave, Mullens, WV 25882 Phone: 304-294-5353 |