Provider Demographics
NPI:1467032813
Name:LOWES COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:LOWES COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PERSEPHONE
Authorized Official - Middle Name:ROSHALL
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S
Authorized Official - Phone:662-299-4061
Mailing Address - Street 1:9851 HIGHWAY 178 STE A
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-3214
Mailing Address - Country:US
Mailing Address - Phone:662-299-4061
Mailing Address - Fax:662-874-6809
Practice Address - Street 1:9851 HIGHWAY 178 STE A
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-3214
Practice Address - Country:US
Practice Address - Phone:662-299-4061
Practice Address - Fax:662-874-6809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty