Provider Demographics
NPI:1265865174
Name:LOWELL, ALIZAH K (LCSW)
Entity Type:Individual
Prefix:
First Name:ALIZAH
Middle Name:K
Last Name:LOWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 W 72ND ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3250
Mailing Address - Country:US
Mailing Address - Phone:646-543-8858
Mailing Address - Fax:
Practice Address - Street 1:155 W 72ND ST
Practice Address - Street 2:SUITE 407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3250
Practice Address - Country:US
Practice Address - Phone:646-543-8858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0781501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical