Provider Demographics
NPI:1902113095
Name:BOWERSOCK, LOIS EILEEN (LCDC, MA)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:EILEEN
Last Name:BOWERSOCK
Suffix:
Gender:F
Credentials:LCDC, MA
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:E
Other - Last Name:THOMSON-BOWERSOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCDC, MA, ADC II, CE
Mailing Address - Street 1:2441 HIGH TIMBERS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1053
Mailing Address - Country:US
Mailing Address - Phone:281-782-6755
Mailing Address - Fax:
Practice Address - Street 1:2441 HIGH TIMBERS DR STE 110
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1053
Practice Address - Country:US
Practice Address - Phone:281-782-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7836101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)