Provider Demographics
NPI:1922128065
Name:LOWE, CARYN JANE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CARYN
Middle Name:JANE
Last Name:LOWE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 HUBBARD LN
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-4802
Mailing Address - Country:US
Mailing Address - Phone:707-442-4738
Mailing Address - Fax:707-444-3522
Practice Address - Street 1:3015 HUBBARD LN
Practice Address - Street 2:SUITE 4
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4802
Practice Address - Country:US
Practice Address - Phone:707-442-4738
Practice Address - Fax:707-444-3522
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS14412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ42213ZMedicare ID - Type UnspecifiedIDENTIFICATION NUMBER