Provider Demographics
NPI:1053830083
Name:LOWERY, KASSANDRA ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KASSANDRA
Middle Name:ELIZABETH
Last Name:LOWERY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9102 N MERIDIAN ST STE 550
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1899
Mailing Address - Country:US
Mailing Address - Phone:614-448-6693
Mailing Address - Fax:
Practice Address - Street 1:10291 N MERIDIAN ST STE 310
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46290-1083
Practice Address - Country:US
Practice Address - Phone:176-721-9703
Practice Address - Fax:317-672-1971
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043448B103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical