Provider Demographics
NPI:1053608760
Name:BOWERS, KIM LEANNE (LCPC)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:LEANNE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:LEANNE
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC, LCAC
Mailing Address - Street 1:6265 ROCK CHALK DR STE 301
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-5232
Mailing Address - Country:US
Mailing Address - Phone:620-364-2378
Mailing Address - Fax:
Practice Address - Street 1:6265 ROCK CHALK DR STE 301
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-5232
Practice Address - Country:US
Practice Address - Phone:913-327-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2385101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health