Provider Demographics
NPI:1629538129
Name:ROWE, JOHN GARY (MSW, LSW, LMSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:GARY
Last Name:ROWE
Suffix:
Gender:M
Credentials:MSW, LSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4812 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3723
Mailing Address - Country:US
Mailing Address - Phone:970-472-4204
Mailing Address - Fax:
Practice Address - Street 1:4812 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3723
Practice Address - Country:US
Practice Address - Phone:970-472-4204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009922109104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker