Provider Demographics
NPI:1639429806
Name:STOWE, JAMES NELSON (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:NELSON
Last Name:STOWE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 GRIST MILL CT
Mailing Address - Street 2:
Mailing Address - City:AMBER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-4205
Mailing Address - Country:US
Mailing Address - Phone:267-272-2819
Mailing Address - Fax:610-660-7731
Practice Address - Street 1:212 GRIST MILL CT
Practice Address - Street 2:
Practice Address - City:AMBER
Practice Address - State:PA
Practice Address - Zip Code:19002-4205
Practice Address - Country:US
Practice Address - Phone:267-272-2819
Practice Address - Fax:610-660-7731
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
PAPC006130101YP2500X
PAPC6130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025537100001Medicaid