Provider Demographics
NPI:1275759151
Name:LOWERY, CAROLYN M (MFT)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:LOWERY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 ROSA L PARKS BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2621
Mailing Address - Country:US
Mailing Address - Phone:615-428-3552
Mailing Address - Fax:
Practice Address - Street 1:915 ROSA L PARKS BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2621
Practice Address - Country:US
Practice Address - Phone:615-428-3552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist