Provider Demographics
NPI:1013089150
Name:LOWRY, DONNA J (MA LPC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:LOWRY
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:L
Other - Last Name:PELLETIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:SO WOODSTOCK
Mailing Address - State:CT
Mailing Address - Zip Code:06267-0006
Mailing Address - Country:US
Mailing Address - Phone:860-928-9789
Mailing Address - Fax:860-963-0866
Practice Address - Street 1:10 BEECHES LANE
Practice Address - Street 2:
Practice Address - City:SO WOODSTOCK
Practice Address - State:CT
Practice Address - Zip Code:06267
Practice Address - Country:US
Practice Address - Phone:860-928-9789
Practice Address - Fax:860-963-0866
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000212103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
400976OtherMAGELLAN
300686OtherMHN
240000212CT01OtherANTHEM BCBS