Provider Demographics
NPI:1629488036
Name:LOWELL, BETTY (LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:LOWELL
Suffix:
Gender:F
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 44TH STREET SW
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418
Mailing Address - Country:US
Mailing Address - Phone:616-260-5615
Mailing Address - Fax:616-235-2099
Practice Address - Street 1:2845 44TH STREET SW
Practice Address - Street 2:SUITE 120
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418
Practice Address - Country:US
Practice Address - Phone:616-260-5615
Practice Address - Fax:616-805-4839
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010660101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional