Provider Demographics
NPI:1740659663
Name:LOWENTRITT, STACEY FLANAGAN (LCSW-BACS)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:FLANAGAN
Last Name:LOWENTRITT
Suffix:
Gender:F
Credentials:LCSW-BACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 ANNUNCIATION ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-1004
Mailing Address - Country:US
Mailing Address - Phone:504-495-5080
Mailing Address - Fax:
Practice Address - Street 1:3525 PRYTANIA ST
Practice Address - Street 2:SUITE 402
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3500
Practice Address - Country:US
Practice Address - Phone:504-495-5080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA94401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical