Provider Demographics
NPI:1659978294
Name:LOWREY, BRETT
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:LOWREY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 DAWSON COMMONS CIR STE 400
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-6269
Mailing Address - Country:US
Mailing Address - Phone:706-344-1263
Mailing Address - Fax:
Practice Address - Street 1:400 DAWSON COMMONS CIR STE 400
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6269
Practice Address - Country:US
Practice Address - Phone:706-344-1263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1008101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)