Provider Demographics
NPI:1972830552
Name:LOWER, ELIZA PAIGE (LISW)
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:PAIGE
Last Name:LOWER
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 1:305 CREEKSIDE DR SW
Mailing Address - Street 2:
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-2619
Mailing Address - Country:US
Mailing Address - Phone:515-979-4743
Mailing Address - Fax:
Practice Address - Street 1:2575 N ANKENY BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4710
Practice Address - Country:US
Practice Address - Phone:515-526-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007302101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health