Provider Demographics
NPI:1518155571
Name:LOWE, SHERRY (CDCA)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:BOUTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCA
Mailing Address - Street 1:107 OREGONIA RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-3903
Mailing Address - Country:US
Mailing Address - Phone:513-695-2411
Mailing Address - Fax:513-695-2309
Practice Address - Street 1:201 READING RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1666
Practice Address - Country:US
Practice Address - Phone:513-398-2551
Practice Address - Fax:513-459-7300
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70431101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)