Provider Demographics
NPI:1871756023
Name:BOWER, JENNIFER LYNN (LMSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNN
Last Name:BOWER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:LENNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:26329 COUNTY ROAD 375
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071
Mailing Address - Country:US
Mailing Address - Phone:269-501-8235
Mailing Address - Fax:269-343-5913
Practice Address - Street 1:605 HOWARD ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-1919
Practice Address - Country:US
Practice Address - Phone:269-501-8235
Practice Address - Fax:269-343-5913
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801087228104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker