Provider Demographics
NPI:1629284054
Name:MARLOWE, JAMES ROBERT II (MDIV, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:MARLOWE
Suffix:II
Gender:M
Credentials:MDIV, PHD
Other - Prefix:DR
Other - First Name:BOB
Other - Middle Name:
Other - Last Name:MARLOWE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MDIV, PHD
Mailing Address - Street 1:145 GREENWING CT
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9015
Mailing Address - Country:US
Mailing Address - Phone:502-863-0105
Mailing Address - Fax:502-863-0105
Practice Address - Street 1:145 GREENWING CT
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9015
Practice Address - Country:US
Practice Address - Phone:502-863-0105
Practice Address - Fax:502-863-0105
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYNONE REQUIRED101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor