Provider Demographics
NPI:1700836954
Name:LOEWENBACH, MIRIAM E (LCSW:BCD)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:E
Last Name:LOEWENBACH
Suffix:
Gender:F
Credentials:LCSW:BCD
Other - Prefix:MRS
Other - First Name:MIRIAM
Other - Middle Name:L
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5324 WESTOVER LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-2455
Mailing Address - Country:US
Mailing Address - Phone:757-420-9344
Mailing Address - Fax:
Practice Address - Street 1:1015 EDEN WAY N
Practice Address - Street 2:SUITE D
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2787
Practice Address - Country:US
Practice Address - Phone:757-410-0072
Practice Address - Fax:757-410-7290
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040004851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical