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Contact Information

BOWLING GREEN STATE UNIVERSITY
822 E MERRY STREET BOWLING GREEN STATE UNIVERSITY
300 PSYCHOLOGY BUILDING
BOWLING GREEN, OH43403
 Phone: 419-372-2540
 Fax: 419-372-2533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BOWLING GREEN STATE UNIVERSITY

NPI # 1083921787
LBN Legal business name BOWLING GREEN STATE UNIVERSITY
Authorized official THERESA KELSO - (ADMINISTRATIVE ASSISTANT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/02/2010
Last updated 07/18/2018 - About 8 years ago
Identifiers
OH License # 6697
OH Medicaid 0747240
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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