Provider Demographics
NPI:1336431014
Name:ROWE, LESIA DANELL (LCSW, PHD)
Entity Type:Individual
Prefix:MRS
First Name:LESIA
Middle Name:DANELL
Last Name:ROWE
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 E INDIANA ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7448
Mailing Address - Country:US
Mailing Address - Phone:812-401-8008
Mailing Address - Fax:812-401-8201
Practice Address - Street 1:7300 E INDIANA ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7448
Practice Address - Country:US
Practice Address - Phone:812-401-8008
Practice Address - Fax:812-401-8201
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003413A104100000X
IN200242770A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1134206535OtherGROUP NPI