Individual
TRISTAN GAGE BOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LGSW
Contact information
Practice address
5004 ELK RIVER RD, ELKVIEW, WV 25701
(304) 759-9835
Mailing address
5004 ELK RIVER RD, ELKVIEW, WV 25701
(304) 759-9835
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
BP00947009
WV
1041C0700X
Clinical Social Worker
Primary
BP00947009
WV
Other
Enumeration date
11/18/2024
Last updated
05/08/2026
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