Provider Demographics
NPI:1861688491
Name:LOWELL, SUSAN L (LISW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:LOWELL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 E WATER ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-2525
Mailing Address - Country:US
Mailing Address - Phone:419-609-9955
Mailing Address - Fax:
Practice Address - Street 1:143 E WATER ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-2525
Practice Address - Country:US
Practice Address - Phone:419-609-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0097581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical