Provider Demographics
NPI:1275829103
Name:LOWELL, ROBERT OWEN (CDP, LMHC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:OWEN
Last Name:LOWELL
Suffix:
Gender:M
Credentials:CDP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 BOREN AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1406
Mailing Address - Country:US
Mailing Address - Phone:201-205-1096
Mailing Address - Fax:
Practice Address - Street 1:1930 BOREN AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1406
Practice Address - Country:US
Practice Address - Phone:201-205-1096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP 00000005101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)