Provider Demographics
NPI:1649051327
Name:LOWREY-GREEN, DEANNA (LMSW)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:LOWREY-GREEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 W AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:GIDDINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78942-3205
Mailing Address - Country:US
Mailing Address - Phone:979-540-2980
Mailing Address - Fax:979-542-9565
Practice Address - Street 1:165 W AUSTIN ST
Practice Address - Street 2:
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78942-3205
Practice Address - Country:US
Practice Address - Phone:979-540-2980
Practice Address - Fax:979-542-9565
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52626104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker