Provider Demographics
NPI:1760005615
Name:LOWERY, ERIK (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:
Last Name:LOWERY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 E MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7356
Mailing Address - Country:US
Mailing Address - Phone:917-622-3153
Mailing Address - Fax:
Practice Address - Street 1:276 E MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7356
Practice Address - Country:US
Practice Address - Phone:302-480-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0000117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE810959824Medicaid